Provider Demographics
NPI:1316371107
Name:HASSELL AFL HOME INC
Entity Type:Organization
Organization Name:HASSELL AFL HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-264-1507
Mailing Address - Street 1:106 CHENEY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4523
Mailing Address - Country:US
Mailing Address - Phone:919-264-1507
Mailing Address - Fax:
Practice Address - Street 1:106 CHENEY CT
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4523
Practice Address - Country:US
Practice Address - Phone:919-264-1507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities