Provider Demographics
NPI:1083754642
Name:HAMMOND STRAWBERRY FIELDS, INC
Entity Type:Organization
Organization Name:HAMMOND STRAWBERRY FIELDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-542-1959
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-0218
Mailing Address - Country:US
Mailing Address - Phone:985-542-1959
Mailing Address - Fax:985-542-6778
Practice Address - Street 1:116 W THOMAS ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-3251
Practice Address - Country:US
Practice Address - Phone:985-542-1959
Practice Address - Fax:985-542-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5784251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1539406OtherPROVIDER NUMBER