Provider Demographics
NPI:1518218858
Name:HOUSE OF HOPE HOUSE OF FAITH
Entity Type:Organization
Organization Name:HOUSE OF HOPE HOUSE OF FAITH
Other - Org Name:HOUSE OF HOPE RECOVERY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER, SENIOR ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:FIDDLER
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:760-403-3531
Mailing Address - Street 1:13287 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-7251
Mailing Address - Country:US
Mailing Address - Phone:760-701-0175
Mailing Address - Fax:760-246-8321
Practice Address - Street 1:11625 CORNELL ST
Practice Address - Street 2:
Practice Address - City:ADELANTO
Practice Address - State:CA
Practice Address - Zip Code:92301-3689
Practice Address - Country:US
Practice Address - Phone:760-701-0175
Practice Address - Fax:760-246-8321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility