MEDICARE: HAMMOND HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	103TP2701X	Group Psychotherapy Psychologist		PA
3	251E00000X	Home Health Agency	HP0123600	NJ
4	251S00000X	Community/Behavioral Health Agency	0400394781	NJ
5	302R00000X	Health Maintenance Organization
6	3140N1450X	Pediatric Skilled Nursing Facility
7	315D00000X	Inpatient Hospice
8	385HR2055X	Child Mental Illness Respite Care
9	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
10	101Y00000X	Counselor	0089575	NJ

General Provider Information

NPI Number	:	1306143672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMMOND HEALTH SERVICES

Provider Business Mailing Address
First Line	:	200 FEDERAL ST
Second Line	:	SUITE 227
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1061
Country	:	US
Telephone Number	:	185-544-7135
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 FEDERAL ST
Second Line	:	SUITE 227
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1061
Country	:	US
Telephone Number	:	185-544-7135
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. GREGORY KEITH HAMMOND
Credential	:
Telephone Number	:	18554471351

Provider Enumeration Date	:	02/22/2011
Last Update Date	:	02/22/2011

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Directions to “HAMMOND HEALTH SERVICES ” Practice Location

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