Provider Demographics
NPI:1326220633
Name:WOMEN OF HOPE RESOURCE CENTER, INC,
Entity Type:Organization
Organization Name:WOMEN OF HOPE RESOURCE CENTER, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:856-435-7000
Mailing Address - Street 1:717 ERIAL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6393
Mailing Address - Country:US
Mailing Address - Phone:856-435-7000
Mailing Address - Fax:
Practice Address - Street 1:717 ERIAL RD
Practice Address - Street 2:SUITE A
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-6393
Practice Address - Country:US
Practice Address - Phone:856-435-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management