Provider Demographics
NPI:1558829283
Name:HOPE RECOVERY CARE CENTER
Entity Type:Organization
Organization Name:HOPE RECOVERY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORITA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:601-519-1731
Mailing Address - Street 1:5260 MANHATTAN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-4258
Mailing Address - Country:US
Mailing Address - Phone:601-519-1731
Mailing Address - Fax:601-982-8177
Practice Address - Street 1:5260 MANHATTAN RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-4258
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health