Provider Demographics
NPI:1407377906
Name:INFINITE HOPE COMMUNITY OUTREACH
Entity Type:Organization
Organization Name:INFINITE HOPE COMMUNITY OUTREACH
Other - Org Name:INFINITE HOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-470-4908
Mailing Address - Street 1:PO BOX 61237
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27661-1237
Mailing Address - Country:US
Mailing Address - Phone:803-470-4908
Mailing Address - Fax:888-552-1363
Practice Address - Street 1:2354 SUMPTER HWY
Practice Address - Street 2:
Practice Address - City:BISHOPVILLE
Practice Address - State:SC
Practice Address - Zip Code:29010
Practice Address - Country:US
Practice Address - Phone:803-470-4908
Practice Address - Fax:888-552-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty