Provider Demographics
NPI:1437501137
Name:AWAKENING HOPE FAMILY SERVICES INC
Entity Type:Organization
Organization Name:AWAKENING HOPE FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:VERLINE
Authorized Official - Middle Name:MONICK
Authorized Official - Last Name:GADDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-738-2564
Mailing Address - Street 1:7156 W 127TH ST
Mailing Address - Street 2:SUITE 125
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1560
Mailing Address - Country:US
Mailing Address - Phone:708-738-2564
Mailing Address - Fax:815-846-2741
Practice Address - Street 1:7156 W 127TH ST
Practice Address - Street 2:SUITE 125
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1560
Practice Address - Country:US
Practice Address - Phone:708-738-2564
Practice Address - Fax:815-846-2741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty