Provider Demographics
NPI:1639474596
Name:HH GROUP HOME, INC.
Entity Type:Organization
Organization Name:HH GROUP HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-216-3322
Mailing Address - Street 1:11541 NW 89TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4114
Mailing Address - Country:US
Mailing Address - Phone:305-216-3322
Mailing Address - Fax:305-558-8208
Practice Address - Street 1:11541 NW 89TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4114
Practice Address - Country:US
Practice Address - Phone:305-216-3322
Practice Address - Fax:305-558-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0026041000320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0026041000Medicaid