Provider Demographics
NPI:1912233719
Name:CHRISTINE HARDWAY INC.
Entity Type:Organization
Organization Name:CHRISTINE HARDWAY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-546-3567
Mailing Address - Street 1:6105A MEMORIAL HIGHWAY
Mailing Address - Street 2:SUITE #1
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615
Mailing Address - Country:US
Mailing Address - Phone:813-546-3567
Mailing Address - Fax:
Practice Address - Street 1:6105 MEMORIAL HIGHWAY
Practice Address - Street 2:SUITE #A-1
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615
Practice Address - Country:US
Practice Address - Phone:813-546-3567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5375251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health