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General NPI Number Information
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NPI Number | 1528198892
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Entity Type | Organization
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Legal Business Name | HAMPTON HOME
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 100 CYPRESS CT
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City | JACKSONVILLE
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State | NC
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Zip | 28540-4029
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Country | US
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Telephone | 910-938-9373
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Fax | 910-938-9373
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Provider Business Mailing Address
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Address Line | 100 CYPRESS CT
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City | JACKSONVILLE
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State | NC
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Zip | 28540-4029
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Country | US
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Telephone | 910-938-9373
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Fax | 910-938-9373
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Authorized Official
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Title or Position | CAP PROVIDER
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Name | CASSANDRA HAMPTON
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Credential |
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Telephone | 910-938-9373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | MHL-067-073
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License Number State | NC
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