Provider Demographics
NPI:1285243550
Name:HATTIE'S PLACE, LLC
Entity type:Organization
Organization Name:HATTIE'S PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-474-7494
Mailing Address - Street 1:2950 NW 187TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-3107
Mailing Address - Country:US
Mailing Address - Phone:786-474-7494
Mailing Address - Fax:954-986-6854
Practice Address - Street 1:2950 NW 187TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-3107
Practice Address - Country:US
Practice Address - Phone:786-474-7494
Practice Address - Fax:954-986-6854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty