Provider Demographics
NPI:1467868620
Name:THE HAMPTON HOUSE FACILITY, LLC
Entity Type:Organization
Organization Name:THE HAMPTON HOUSE FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:706-788-3400
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:GA
Mailing Address - Zip Code:30628-0456
Mailing Address - Country:US
Mailing Address - Phone:706-788-3400
Mailing Address - Fax:706-788-3400
Practice Address - Street 1:432 S FOURTH ST
Practice Address - Street 2:
Practice Address - City:COLBERT
Practice Address - State:GA
Practice Address - Zip Code:30628-3320
Practice Address - Country:US
Practice Address - Phone:706-788-3400
Practice Address - Fax:706-788-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA095-01-022-1311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA095-01-022-1OtherDEPARTMENT OF COMMUNITY HEALTH