=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639611841
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAMPTONS TRAINING INSTITUTE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2016
-----------------------------------------------------
Last Update Date | 11/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12616 111TH AVE
-----------------------------------------------------
City | SOUTH OZONE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11420-1516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-784-2708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1428 GRANADA PL
-----------------------------------------------------
City | FAR ROCKAWAY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11691-1708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MISS CHRISTINE CHARLES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 646-784-2708
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------