Provider Demographics
NPI:1225659121
Name:AMAZING HOPE LLC
Entity Type:Organization
Organization Name:AMAZING HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:BAAFI
Authorized Official - Last Name:OPUNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-338-0607
Mailing Address - Street 1:1749 W APPALOOSA WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4415
Mailing Address - Country:US
Mailing Address - Phone:571-338-0607
Mailing Address - Fax:
Practice Address - Street 1:7103 E ONZA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-9811
Practice Address - Country:US
Practice Address - Phone:571-338-0607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health