Provider Demographics
NPI:1477974061
Name:HOPE FOR HEALTHY HEALING
Entity Type:Organization
Organization Name:HOPE FOR HEALTHY HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SABRENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:4307-437-8917
Mailing Address - Street 1:3208 W SR 426
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8656
Mailing Address - Country:US
Mailing Address - Phone:407-437-8917
Mailing Address - Fax:407-283-7078
Practice Address - Street 1:3208 W SR 426
Practice Address - Street 2:SUITE 1020
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8656
Practice Address - Country:US
Practice Address - Phone:407-437-8917
Practice Address - Fax:407-283-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health