Provider Demographics
NPI:1316561475
Name:CENTER FOR HEALING AND HOPE
Entity Type:Organization
Organization Name:CENTER FOR HEALING AND HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-534-4744
Mailing Address - Street 1:PO BOX 195
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46527-0195
Mailing Address - Country:US
Mailing Address - Phone:574-534-4744
Mailing Address - Fax:574-537-1186
Practice Address - Street 1:400 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46526-2413
Practice Address - Country:US
Practice Address - Phone:574-534-4744
Practice Address - Fax:574-537-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1811906084OtherNPI
IN1316946999OtherNPI
IN1902430580OtherNPI
IN1083063499OtherNPI
IN1205806098OtherNPI
IN1528062932OtherNPI