Provider Demographics
NPI:1396860771
Name:RAY OF HOPE, LLC
Entity Type:Organization
Organization Name:RAY OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEWELIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHUKLA
Authorized Official - Suffix:
Authorized Official - Credentials:MEA
Authorized Official - Phone:989-633-3348
Mailing Address - Street 1:2706 ASHMAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4407
Mailing Address - Country:US
Mailing Address - Phone:989-687-2562
Mailing Address - Fax:989-633-3358
Practice Address - Street 1:2706 ASHMAN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4407
Practice Address - Country:US
Practice Address - Phone:989-633-3348
Practice Address - Fax:989-633-3358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI64736KOtherFINGERPRINITING ID