Provider Demographics
NPI: | 1467639484 |
---|---|
Name: | HOPE RECOVERY SERVICES, INC. |
Entity Type: | Organization |
Organization Name: | HOPE RECOVERY SERVICES, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ALICE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | EDWARDS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LCDC, LPPT DIPLOMATE |
Authorized Official - Phone: | 979-248-5649 |
Mailing Address - Street 1: | PO BOX 2085 |
Mailing Address - Street 2: | |
Mailing Address - City: | ANGLETON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77516-2085 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 979-248-5649 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2100 WEST LOOP S STE 900 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77027-3522 |
Practice Address - Country: | US |
Practice Address - Phone: | 979-291-1824 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-01-22 |
Last Update Date: | 2020-06-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101YA0400X, 101YM0800X, 101YP1600X, 101YP2500X, 133N00000X, 171000000X, 171M00000X, 172V00000X, 174H00000X, 175T00000X, 324500000X, 3245S0500X, 405300000X | ||
TX | 3255 - 3256 | 251B00000X, 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP1600X | Behavioral Health & Social Service Providers | Counselor | Pastoral | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 171000000X | Other Service Providers | Military Health Care Provider | Group - Multi-Specialty | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
No | 172V00000X | Other Service Providers | Community Health Worker | Group - Multi-Specialty | |
No | 174H00000X | Other Service Providers | Health Educator | Group - Multi-Specialty | |
No | 175T00000X | Other Service Providers | Peer Specialist | Group - Multi-Specialty | |
No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Group - Multi-Specialty | |
No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | Group - Multi-Specialty |
No | 405300000X | Other Service Providers | Prevention Professional | Group - Multi-Specialty |