Provider Demographics
NPI:1033615109
Name:CENTER FOR HOPE AND HEALING
Entity Type:Organization
Organization Name:CENTER FOR HOPE AND HEALING
Other - Org Name:THERAPYUTAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:KINGHORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, SAP
Authorized Official - Phone:385-254-3522
Mailing Address - Street 1:2940 W MAPLE LOOP DR
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5661
Mailing Address - Country:US
Mailing Address - Phone:385-254-3522
Mailing Address - Fax:
Practice Address - Street 1:2940 W MAPLE LOOP DR
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5661
Practice Address - Country:US
Practice Address - Phone:385-254-3522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53066261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center