Provider Demographics
NPI:1093316697
Name:HOPE OF SOLACE GROUP LLC
Entity Type:Organization
Organization Name:HOPE OF SOLACE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:984-200-4653
Mailing Address - Street 1:5422 GUNNETTE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-5587
Mailing Address - Country:US
Mailing Address - Phone:984-200-4653
Mailing Address - Fax:
Practice Address - Street 1:5440 ATLANTIC SPRINGS RD STE 109
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-1855
Practice Address - Country:US
Practice Address - Phone:984-200-4653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE OF SOLACE GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care