Provider Demographics
NPI:1295034197
Name:MERCHANTS OF HOPE COMMUNITY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:MERCHANTS OF HOPE COMMUNITY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CHINA
Authorized Official - Last Name:EJIRIKA
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:512-947-2305
Mailing Address - Street 1:7901 CAMERON RD STE 3-307
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-3843
Mailing Address - Country:US
Mailing Address - Phone:512-947-2305
Mailing Address - Fax:512-382-9458
Practice Address - Street 1:4610 CASTLEMAN DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78725-1718
Practice Address - Country:US
Practice Address - Phone:512-276-7038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child