Provider Demographics
NPI:1407579832
Name:RAYS OF HOPE INTERVENTION
Entity Type:Organization
Organization Name:RAYS OF HOPE INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:STOCKTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-307-6688
Mailing Address - Street 1:840 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-2760
Mailing Address - Country:US
Mailing Address - Phone:606-307-6688
Mailing Address - Fax:
Practice Address - Street 1:950 N MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-1557
Practice Address - Country:US
Practice Address - Phone:606-307-6688
Practice Address - Fax:606-396-8006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health