Provider Demographics
NPI:1235504754
Name:HOPE HOUSE CORP
Entity Type:Organization
Organization Name:HOPE HOUSE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:HOOK
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:714-766-7490
Mailing Address - Street 1:707 N ANAHEIM BLVD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2652
Mailing Address - Country:US
Mailing Address - Phone:714-398-0165
Mailing Address - Fax:
Practice Address - Street 1:707 N ANAHEIM BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2652
Practice Address - Country:US
Practice Address - Phone:714-398-0165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300034AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00OtherIRIS - PROD