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General NPI Number Information
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NPI Number | 1801678420
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Entity Type | Organization
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Legal Business Name | T HASKINS FOUNDATION
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 1111 SEYMOUR DR
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City | ASHTABULA
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State | OH
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Zip | 44004-5511
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Country | US
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Telephone | 440-813-6403
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1305
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City | ASHTABULA
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State | OH
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Zip | 44005-1305
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Country | US
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Telephone | 440-813-6403
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. NATHANIEL DANTE HASKINS
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Credential | DSP
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Telephone | 440-813-6403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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