Provider Demographics
NPI:1528210689
Name:TASK FORCE ON DEOMESTIC VIOLENCE, 'HOPE, INC'
Entity Type:Organization
Organization Name:TASK FORCE ON DEOMESTIC VIOLENCE, 'HOPE, INC'
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, ACSW
Authorized Official - Phone:304-367-1100
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26555
Mailing Address - Country:US
Mailing Address - Phone:304-367-1100
Mailing Address - Fax:304-367-0362
Practice Address - Street 1:411 JACKSON STREET
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26555
Practice Address - Country:US
Practice Address - Phone:304-367-1100
Practice Address - Fax:304-367-0362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV10300Medicaid
WV0023902000OtherOLD IDENTIFICATION NUMBER UNDER UNISYS