Provider Demographics
NPI:1376022772
Name:CENTER FOR HOPE & HEALING, LLC
Entity Type:Organization
Organization Name:CENTER FOR HOPE & HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-302-6745
Mailing Address - Street 1:111 PLANTATION CT
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-7772
Mailing Address - Country:US
Mailing Address - Phone:706-302-6745
Mailing Address - Fax:
Practice Address - Street 1:100 SMITH ST STE 1
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-2780
Practice Address - Country:US
Practice Address - Phone:706-668-5035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty