Provider Demographics
NPI:1346777018
Name:HOPEWAY FOUNDATION
Entity Type:Organization
Organization Name:HOPEWAY FOUNDATION
Other - Org Name:HOPEWAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:R
Authorized Official - Last Name:KUROSKI-MAZZEI
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MRO, DFAPA, FASA
Authorized Official - Phone:980-859-2106
Mailing Address - Street 1:1717 SHARON ROAD WEST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210
Mailing Address - Country:US
Mailing Address - Phone:980-859-2106
Mailing Address - Fax:
Practice Address - Street 1:1717 SHARON ROAD WEST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210
Practice Address - Country:US
Practice Address - Phone:980-859-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-060-1328261QM0801X
261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health