Provider Demographics
NPI:1093805541
Name:HOPE THERAPY & CONSULTING SERVICES, INC
Entity Type:Organization
Organization Name:HOPE THERAPY & CONSULTING SERVICES, INC
Other - Org Name:HOPE THERAPY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLAJUNMOKE
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:ILEDARE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:225-926-2645
Mailing Address - Street 1:1121 N. LOBDELL BLVD.
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806
Mailing Address - Country:US
Mailing Address - Phone:225-926-2645
Mailing Address - Fax:
Practice Address - Street 1:1121 N. LOBDELL BLVD.
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-926-2645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT01557F261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1105163Medicaid