Provider Demographics
NPI:1518019173
Name:HOPE CENTER, LLC
Entity Type:Organization
Organization Name:HOPE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-630-4673
Mailing Address - Street 1:204 E INNES ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-5010
Mailing Address - Country:US
Mailing Address - Phone:704-630-4673
Mailing Address - Fax:704-630-4663
Practice Address - Street 1:204 E INNES ST
Practice Address - Street 2:SUITE 260
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5010
Practice Address - Country:US
Practice Address - Phone:704-630-4673
Practice Address - Fax:704-630-4663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1010103TC2200X
NC1965103TC2200X
NC283106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005105Medicaid