Provider Demographics
NPI:1235582404
Name:GREATER HOPE FOUNDATION
Entity Type:Organization
Organization Name:GREATER HOPE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:JD MBA
Authorized Official - Phone:760-256-0432
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92312-0544
Mailing Address - Country:US
Mailing Address - Phone:760-256-0432
Mailing Address - Fax:
Practice Address - Street 1:14344 CAJON AVENUE, SUITE 101, 103
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392
Practice Address - Country:US
Practice Address - Phone:760-243-3999
Practice Address - Fax:760-243-9599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health