Provider Demographics
NPI:1467214304
Name:HOPE4HEALTH CLINIC LLC
Entity Type:Organization
Organization Name:HOPE4HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AIMABLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VUNINGOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-495-7228
Mailing Address - Street 1:2538 E UNIVERSITY DR STE 270
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-6917
Mailing Address - Country:US
Mailing Address - Phone:817-495-7228
Mailing Address - Fax:
Practice Address - Street 1:2538 E UNIVERSITY DR STE 270
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-6917
Practice Address - Country:US
Practice Address - Phone:817-495-7228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty