Provider Demographics
NPI:1558729509
Name:CAYMAN'S HOUSE OF HOPE, INC.
Entity Type:Organization
Organization Name:CAYMAN'S HOUSE OF HOPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-654-2500
Mailing Address - Street 1:311 N POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:FAIR PLAY
Mailing Address - State:MO
Mailing Address - Zip Code:65649-9299
Mailing Address - Country:US
Mailing Address - Phone:417-654-2500
Mailing Address - Fax:
Practice Address - Street 1:311 N POPLAR ST
Practice Address - Street 2:
Practice Address - City:FAIR PLAY
Practice Address - State:MO
Practice Address - Zip Code:65649-9299
Practice Address - Country:US
Practice Address - Phone:417-654-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002575600322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children