Provider Demographics
NPI:1275569949
Name:VALLEY HOPE ASSOCIATION
Entity Type:Organization
Organization Name:VALLEY HOPE ASSOCIATION
Other - Org Name:MOUNDRIDGE VALLEY HOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CONTRACT ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-877-5111
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:103 S WABASH AVE
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-0510
Mailing Address - Country:US
Mailing Address - Phone:785-877-5111
Mailing Address - Fax:785-877-2322
Practice Address - Street 1:200 S. AVENUE B
Practice Address - Street 2:
Practice Address - City:MOUNDRIDGE
Practice Address - State:KS
Practice Address - Zip Code:67107
Practice Address - Country:US
Practice Address - Phone:620-345-4673
Practice Address - Fax:620-345-4684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY HOPE ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-24
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
461414OtherVALUE OPTIONS PROVIDER #