Provider Demographics
NPI:1114545126
Name:HOPE MOUNTAIN, LLC
Entity Type:Organization
Organization Name:HOPE MOUNTAIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-465-0900
Mailing Address - Street 1:1802 CHAPEL HILLS DR STE A
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3736
Mailing Address - Country:US
Mailing Address - Phone:719-465-0900
Mailing Address - Fax:
Practice Address - Street 1:6565 W JEWELL AVE # 4B1
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-7187
Practice Address - Country:US
Practice Address - Phone:719-465-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)