Provider Demographics
NPI:1356141808
Name:THE HARTAGE FOUNDATION INC.
Entity type:Organization
Organization Name:THE HARTAGE FOUNDATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOMER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARTAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-221-4351
Mailing Address - Street 1:PO BOX 560245
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32856-0245
Mailing Address - Country:US
Mailing Address - Phone:321-221-4435
Mailing Address - Fax:
Practice Address - Street 1:1405 S ORANGE AVE STE 324
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2129
Practice Address - Country:US
Practice Address - Phone:407-820-5750
Practice Address - Fax:407-820-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty