Provider Demographics
NPI: | 1073128716 |
---|---|
Name: | HOPE, LOVE, AND DREAM, INC |
Entity Type: | Organization |
Organization Name: | HOPE, LOVE, AND DREAM, INC |
Other - Org Name: | HOPE, LOVE, AND DREAM, INC |
Other - Org Type: | Former Legal Business Name |
Authorized Official - Title/Position: | FOUNDER/CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | DOMONIQUE |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | RICE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD, IMFT-S |
Authorized Official - Phone: | 216-970-8926 |
Mailing Address - Street 1: | 1491 POLARIS PKWY STE 216 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBUS |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43240-2041 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1542 GROVE HILL DRIVE |
Practice Address - Street 2: | |
Practice Address - City: | COLUMBUS |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43240 |
Practice Address - Country: | US |
Practice Address - Phone: | 614-285-4140 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-09-10 |
Last Update Date: | 2023-07-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
No | 2084P0015X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychosomatic Medicine | Group - Multi-Specialty |