Provider Demographics
NPI:1093485930
Name:ANCHORED HOPE CLINIC, PLLC
Entity Type:Organization
Organization Name:ANCHORED HOPE CLINIC, PLLC
Other - Org Name:ANCHORED HOPE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRITCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:601-376-9144
Mailing Address - Street 1:423 WEATHERSBY RD STE 180
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1132
Mailing Address - Country:US
Mailing Address - Phone:601-376-9144
Mailing Address - Fax:601-429-9300
Practice Address - Street 1:423 WEATHERSBY RD STE 180
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1132
Practice Address - Country:US
Practice Address - Phone:601-376-9144
Practice Address - Fax:601-429-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health