Provider Demographics
NPI:1801678420
Name:T HASKINS FOUNDATION
Entity type:Organization
Organization Name:T HASKINS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:DANTE
Authorized Official - Last Name:HASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DSP
Authorized Official - Phone:440-813-6403
Mailing Address - Street 1:PO BOX 1305
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44005-1305
Mailing Address - Country:US
Mailing Address - Phone:440-813-6403
Mailing Address - Fax:
Practice Address - Street 1:1111 SEYMOUR DR
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-5511
Practice Address - Country:US
Practice Address - Phone:440-813-6403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution