Provider Demographics
NPI:1114030194
Name:THE H.O.P.E. PROGRAM
Entity Type:Organization
Organization Name:THE H.O.P.E. PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-722-0557
Mailing Address - Street 1:11712 VANDOREN LN
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:FL
Mailing Address - Zip Code:32438-5262
Mailing Address - Country:US
Mailing Address - Phone:850-722-0557
Mailing Address - Fax:850-722-9559
Practice Address - Street 1:11712 VANDOREN LN
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:FL
Practice Address - Zip Code:32438-5262
Practice Address - Country:US
Practice Address - Phone:850-722-0557
Practice Address - Fax:850-722-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility