Provider Demographics
NPI:1619623402
Name:HANNAHS HOUSES OF REFUGE
Entity Type:Organization
Organization Name:HANNAHS HOUSES OF REFUGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAKESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:980-395-5039
Mailing Address - Street 1:1509 RICE HOPE CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-6985
Mailing Address - Country:US
Mailing Address - Phone:980-395-5039
Mailing Address - Fax:
Practice Address - Street 1:1509 RICE HOPE CT
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-6985
Practice Address - Country:US
Practice Address - Phone:980-395-5039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty