Provider Demographics
NPI:1881253151
Name:HAMMOND CENTER, LLC
Entity type:Organization
Organization Name:HAMMOND CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/RN
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CRISWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-236-7592
Mailing Address - Street 1:907 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2075
Mailing Address - Country:US
Mailing Address - Phone:641-269-5454
Mailing Address - Fax:641-269-5455
Practice Address - Street 1:907 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2075
Practice Address - Country:US
Practice Address - Phone:641-269-5454
Practice Address - Fax:641-269-5455
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST FRANCIS MANOR INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility