Provider Demographics
NPI:1306143672
Name:HAMMOND HEALTH SERVICES
Entity type:Organization
Organization Name:HAMMOND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1855-447-1351
Mailing Address - Street 1:200 FEDERAL ST
Mailing Address - Street 2:SUITE 227
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1061
Mailing Address - Country:US
Mailing Address - Phone:185-544-7135
Mailing Address - Fax:
Practice Address - Street 1:200 FEDERAL ST
Practice Address - Street 2:SUITE 227
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1061
Practice Address - Country:US
Practice Address - Phone:185-544-7135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 302R00000X, 3140N1450X, 315D00000X, 385HR2055X, 385HR2060X
PA103TP2701X
NJHP0123600251E00000X
NJ0400394781251S00000X
NJ0089575101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child