Provider Demographics
NPI:1477559847
Name:OUR LADY OF HOPE HEALTH CENTER, INC
Entity Type:Organization
Organization Name:OUR LADY OF HOPE HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOM
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-360-1960
Mailing Address - Street 1:13700 N GAYTON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233
Mailing Address - Country:US
Mailing Address - Phone:804-360-1960
Mailing Address - Fax:804-364-0737
Practice Address - Street 1:13700 N GAYTON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233
Practice Address - Country:US
Practice Address - Phone:804-360-1960
Practice Address - Fax:804-364-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2648314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004953118Medicaid
VA004953118Medicaid