Provider Demographics
NPI:1104196617
Name:HOPE ADVANCEMENT OF TEXAS, INC
Entity Type:Organization
Organization Name:HOPE ADVANCEMENT OF TEXAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BOARD MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEMETRIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-956-3062
Mailing Address - Street 1:610 UPTOWN BLVD
Mailing Address - Street 2:2000
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3527
Mailing Address - Country:US
Mailing Address - Phone:704-956-3062
Mailing Address - Fax:704-496-2088
Practice Address - Street 1:610 UPTOWN BLVD
Practice Address - Street 2:2000
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3527
Practice Address - Country:US
Practice Address - Phone:704-956-3062
Practice Address - Fax:704-496-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-01
Last Update Date:2012-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 104100000X, 1041C0700X, 106H00000X
TX10518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty