Provider Demographics
NPI:1235536160
Name:HOPEWELL HEALTHCARE SERVICES,LLC
Entity Type:Organization
Organization Name:HOPEWELL HEALTHCARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:AYO
Authorized Official - Last Name:ADEOSUN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:208-599-4051
Mailing Address - Street 1:2233 WATT AVE
Mailing Address - Street 2:SUITE 282
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0509
Mailing Address - Country:US
Mailing Address - Phone:916-380-5797
Mailing Address - Fax:
Practice Address - Street 1:2233 WATT AVE
Practice Address - Street 2:SUITE 282
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0509
Practice Address - Country:US
Practice Address - Phone:916-380-5797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235536160Medicaid