Provider Demographics
NPI:1184222671
Name:HOPE SOARS BEHAVIORAL HEALTH INC.
Entity Type:Organization
Organization Name:HOPE SOARS BEHAVIORAL HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMESINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:760-220-7149
Mailing Address - Street 1:12127 MALL BLVD # 148
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-7665
Mailing Address - Country:US
Mailing Address - Phone:760-220-7149
Mailing Address - Fax:
Practice Address - Street 1:12127 MALL BLVD # 148
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-7665
Practice Address - Country:US
Practice Address - Phone:442-242-1724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty