Provider Demographics
NPI:1235461773
Name:H.O.P.E.
Entity Type:Organization
Organization Name:H.O.P.E.
Other - Org Name:H.O.P.E. PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:MARLIN
Authorized Official - Last Name:KIRKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC
Authorized Official - Phone:850-643-4600
Mailing Address - Street 1:11712 VANDOREN LN
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:FL
Mailing Address - Zip Code:32438-5262
Mailing Address - Country:US
Mailing Address - Phone:850-722-6117
Mailing Address - Fax:850-722-8712
Practice Address - Street 1:11712 VANDOREN LN
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:FL
Practice Address - Zip Code:32438-5262
Practice Address - Country:US
Practice Address - Phone:850-722-6117
Practice Address - Fax:850-722-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children