Provider Demographics
NPI:1154065597
Name:REESTABLISHING HOPE INC
Entity Type:Organization
Organization Name:REESTABLISHING HOPE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:DD, MSW, LSW, CADC,
Authorized Official - Phone:170-866-3686
Mailing Address - Street 1:3850 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-2563
Mailing Address - Country:US
Mailing Address - Phone:708-864-1684
Mailing Address - Fax:
Practice Address - Street 1:17577 KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2051
Practice Address - Country:US
Practice Address - Phone:815-418-6577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REESTABLISHING HOPE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty