Provider Demographics
NPI:1093452831
Name:HOUSE OF HOPE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:HOUSE OF HOPE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:FOLASAYO
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLADOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-421-1120
Mailing Address - Street 1:115 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5201
Mailing Address - Country:US
Mailing Address - Phone:520-421-1120
Mailing Address - Fax:520-421-2877
Practice Address - Street 1:556 W MIRAGE LOOP
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6133
Practice Address - Country:US
Practice Address - Phone:520-421-1120
Practice Address - Fax:520-421-2877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances