Provider Demographics
NPI:1114225745
Name:HOPE HOSPICE AND COMMUNITY SERVICES, INC
Entity Type:Organization
Organization Name:HOPE HOSPICE AND COMMUNITY SERVICES, INC
Other - Org Name:HOPE COMFORT CARE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKWITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-433-8073
Mailing Address - Street 1:9470 HEALTHPARK CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3600
Mailing Address - Country:US
Mailing Address - Phone:239-433-8073
Mailing Address - Fax:239-482-7897
Practice Address - Street 1:9470 HEALTHPARK CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3600
Practice Address - Country:US
Practice Address - Phone:239-433-8073
Practice Address - Fax:239-482-7897
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE HOSPICE AND COMMUNITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-07
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9176207Q00000X
FLNP972142363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000901900Medicaid