Provider Demographics
NPI:1679752000
Name:HAMPTON SENIOR MANAGMENT INC
Entity Type:Organization
Organization Name:HAMPTON SENIOR MANAGMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDER
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:JOHNSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-387-1830
Mailing Address - Street 1:PO BOX 771019
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34477-1019
Mailing Address - Country:US
Mailing Address - Phone:352-387-1830
Mailing Address - Fax:352-873-0237
Practice Address - Street 1:5762 SW 60TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5677
Practice Address - Country:US
Practice Address - Phone:352-237-4544
Practice Address - Fax:352-237-4442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9076385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care