Provider Demographics
NPI:1497426159
Name:HOPE CARE SERVICES, LLC
Entity Type:Organization
Organization Name:HOPE CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YETUNDE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ADEGOROYE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH
Authorized Official - Phone:443-850-7624
Mailing Address - Street 1:3110 KARENDALE CIR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2028
Mailing Address - Country:US
Mailing Address - Phone:443-850-7624
Mailing Address - Fax:
Practice Address - Street 1:5688 UTRECHT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-2905
Practice Address - Country:US
Practice Address - Phone:443-850-7624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW21208319Medicaid