Provider Demographics
NPI:1518228840
Name:GIFT OF HOPE&HEALING INC
Entity Type:Organization
Organization Name:GIFT OF HOPE&HEALING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:AWANYAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-565-2043
Mailing Address - Street 1:6630 S VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-1650
Mailing Address - Country:US
Mailing Address - Phone:213-984-5742
Mailing Address - Fax:
Practice Address - Street 1:6630 S VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-1650
Practice Address - Country:US
Practice Address - Phone:213-984-5742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty