Provider Demographics
NPI:1407429319
Name:HOPE BHR LLC
Entity Type:Organization
Organization Name:HOPE BHR LLC
Other - Org Name:HOPE BHR LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:ATHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHDAIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-370-1745
Mailing Address - Street 1:3732 S 72ND LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-7842
Mailing Address - Country:US
Mailing Address - Phone:480-370-1745
Mailing Address - Fax:
Practice Address - Street 1:3732 S 72ND LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-7842
Practice Address - Country:US
Practice Address - Phone:480-370-1745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty