Provider Demographics
NPI:1972056968
Name:HAMPTON HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:HAMPTON HEALTH CARE SERVICES, INC.
Other - Org Name:HAMPTON HEALTH CARE SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/FOUNDER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:954-549-9564
Mailing Address - Street 1:7947 JOHNSON ST APT 11
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6847
Mailing Address - Country:US
Mailing Address - Phone:954-549-9564
Mailing Address - Fax:
Practice Address - Street 1:7947 JOHNSON ST APT 11
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-549-9564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 252Y00000X
FLPN5154215320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019738500Medicaid
FL018479000Medicaid
FL018914200Medicaid