Healthcare Provider Details
I. General information
NPI: 1821319039
Provider Name (Legal Business Name): HAMPSHIRE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2010
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
HC 63 BOX 2580
ROMNEY WV
26757-9718
US
IV. Provider business mailing address
2812 DINNER BELL FIVE FORKS RD
FARMINGTON PA
15437-1049
US
V. Phone/Fax
- Phone: 304-822-7527
- Fax: 304-822-7330
- Phone: 724-329-8289
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | SLP-1249 |
| License Number State | WV |
VIII. Authorized Official
Name:
ALICE
MAY
RISHEL
Title or Position: SPEECH THERAPIST
Credential: M.S.CCC,SLP
Phone: 724-984-3802