Provider Demographics
NPI:1073957726
Name:HOPE PROFESSIONAL SERVICES,P.S.C.
Entity Type:Organization
Organization Name:HOPE PROFESSIONAL SERVICES,P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHSYCOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:VIRGEN
Authorized Official - Middle Name:DEL C
Authorized Official - Last Name:RENTA
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:787-220-9971
Mailing Address - Street 1:URB. BRISAS DEL PRADO 2266 CALLE JILGUERO H-33
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757
Mailing Address - Country:US
Mailing Address - Phone:787-220-9971
Mailing Address - Fax:
Practice Address - Street 1:URB. BRISAS DEL PRADO 2266 CALLE JILGUERO H-33
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-220-9971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003644261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service