Provider Demographics
NPI:1578682084
Name:HAMILTON SERVICES, LLC
Entity Type:Organization
Organization Name:HAMILTON SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-389-1142
Mailing Address - Street 1:975 REVOLUTION MILL DR.
Mailing Address - Street 2:STUDIO 1
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5041
Mailing Address - Country:US
Mailing Address - Phone:336-389-1142
Mailing Address - Fax:336-373-3996
Practice Address - Street 1:975 REVOLUTION MILL DR.
Practice Address - Street 2:STUDIO 1
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5041
Practice Address - Country:US
Practice Address - Phone:336-389-1142
Practice Address - Fax:336-373-3996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
NCMHL-041-751251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300614Medicaid