Provider Demographics
NPI:1598808446
Name:HAMMER RESIDENCES, INC
Entity Type:Organization
Organization Name:HAMMER RESIDENCES, INC
Other - Org Name:HAMMER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-277-2422
Mailing Address - Street 1:1909 WAYZATA BLVD
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-2047
Mailing Address - Country:US
Mailing Address - Phone:952-473-1261
Mailing Address - Fax:952-473-8629
Practice Address - Street 1:1909 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-2047
Practice Address - Country:US
Practice Address - Phone:952-473-1261
Practice Address - Fax:952-473-8629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities