Provider Demographics
NPI:1558508853
Name:HOPE HOUSE, INC.
Entity Type:Organization
Organization Name:HOPE HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:L
Authorized Official - Middle Name:G
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-625-4673
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-0003
Mailing Address - Country:US
Mailing Address - Phone:205-626-4673
Mailing Address - Fax:
Practice Address - Street 1:1000 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-2534
Practice Address - Country:US
Practice Address - Phone:205-625-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL33905090Medicaid