Provider Demographics
NPI:1043837560
Name:JOURNEY OF HOPE COMMUNITY HOUSING LLC
Entity Type:Organization
Organization Name:JOURNEY OF HOPE COMMUNITY HOUSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-385-7899
Mailing Address - Street 1:1064 162ND LN NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-4822
Mailing Address - Country:US
Mailing Address - Phone:612-385-5708
Mailing Address - Fax:
Practice Address - Street 1:157 EMERSON AVE W
Practice Address - Street 2:
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-2126
Practice Address - Country:US
Practice Address - Phone:612-385-5708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251B00000XAgenciesCase Management
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility