Provider Demographics
NPI:1932928694
Name:HATTIE'S HOME
Entity type:Organization
Organization Name:HATTIE'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-527-9360
Mailing Address - Street 1:256 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03835-3734
Mailing Address - Country:US
Mailing Address - Phone:508-527-9360
Mailing Address - Fax:
Practice Address - Street 1:256 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NH
Practice Address - Zip Code:03835-3734
Practice Address - Country:US
Practice Address - Phone:508-527-9360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility