Provider Demographics
NPI:1366855140
Name:HOPE-1 ADULT DAY CARE CORPORATION
Entity Type:Organization
Organization Name:HOPE-1 ADULT DAY CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDDLEBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-867-4673
Mailing Address - Street 1:2041 MCLARAN AVE
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-3768
Mailing Address - Country:US
Mailing Address - Phone:314-867-4673
Mailing Address - Fax:314-388-2703
Practice Address - Street 1:2041 MCLARAN AVE
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:MO
Practice Address - Zip Code:63136-3768
Practice Address - Country:US
Practice Address - Phone:314-867-4673
Practice Address - Fax:314-388-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care