Provider Demographics
NPI:1497093520
Name:WORD OF HOPE MINISTRIES
Entity Type:Organization
Organization Name:WORD OF HOPE MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBSTANCE ABUSE COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:15653-130
Authorized Official - Phone:414-447-1965
Mailing Address - Street 1:2677 N 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-2505
Mailing Address - Country:US
Mailing Address - Phone:414-447-1965
Mailing Address - Fax:414-447-1964
Practice Address - Street 1:2677 N 40TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-2505
Practice Address - Country:US
Practice Address - Phone:414-447-1965
Practice Address - Fax:414-447-1964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15653-130252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency