Provider Demographics
NPI:1053689828
Name:DAWN OF HOPE, INC
Entity Type:Organization
Organization Name:DAWN OF HOPE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-434-5600
Mailing Address - Street 1:P.O. BOX 30
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37605-0030
Mailing Address - Country:US
Mailing Address - Phone:423-434-5600
Mailing Address - Fax:423-975-6976
Practice Address - Street 1:500 E OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-3465
Practice Address - Country:US
Practice Address - Phone:423-434-5600
Practice Address - Fax:423-975-6976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X
TNL000000008390320900000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNL000000022077OtherSTATE OF TENNESSEE - DIDD
TN00137Medicaid
TNPSS0000000017OtherSTATE OF TENNESSEE - DEPARTMENT OF HEALTH