Provider Demographics
NPI:1376133702
Name:HOPE BEHAVIORAL HEALTH INC
Entity Type:Organization
Organization Name:HOPE BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELYSEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NJONTU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:781-534-4658
Mailing Address - Street 1:353 W CENTER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1625
Mailing Address - Country:US
Mailing Address - Phone:781-534-4658
Mailing Address - Fax:
Practice Address - Street 1:35 MITCHELL ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-1903
Practice Address - Country:US
Practice Address - Phone:781-534-4658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4486985298OtherPECOS ID