Provider Demographics
NPI:1053813972
Name:HIDE AWAY PROJECT LLC
Entity Type:Organization
Organization Name:HIDE AWAY PROJECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANEAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-407-8032
Mailing Address - Street 1:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:REEDSPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97467-0132
Mailing Address - Country:US
Mailing Address - Phone:406-407-8032
Mailing Address - Fax:214-602-5295
Practice Address - Street 1:1877 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:REEDSPORT
Practice Address - State:OR
Practice Address - Zip Code:97467-1148
Practice Address - Country:US
Practice Address - Phone:406-407-8032
Practice Address - Fax:214-602-5295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty