Provider Demographics
NPI:1376607549
Name:HOPE'S PLACE INC.
Entity Type:Organization
Organization Name:HOPE'S PLACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:606-325-4737
Mailing Address - Street 1:1100 GREENUP AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7523
Mailing Address - Country:US
Mailing Address - Phone:606-325-4737
Mailing Address - Fax:606-325-9168
Practice Address - Street 1:1100 GREENUP AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7523
Practice Address - Country:US
Practice Address - Phone:606-325-4737
Practice Address - Fax:606-325-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY13000021Medicaid