Provider Demographics
NPI:1568743185
Name:JANIE HAMMIT MEMORIAL, INC.
Entity Type:Organization
Organization Name:JANIE HAMMIT MEMORIAL, INC.
Other - Org Name:JANIE HAMMIT CHILDREN'S HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERALD
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-669-9221
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24203-0605
Mailing Address - Country:US
Mailing Address - Phone:276-669-9221
Mailing Address - Fax:276-669-9221
Practice Address - Street 1:1225 JANI HAMMIT DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-4880
Practice Address - Country:US
Practice Address - Phone:276-669-9221
Practice Address - Fax:276-669-9221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACO-455-11253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency