Provider Demographics
NPI:1568015048
Name:ANCHORS OF HOPE, LLC
Entity Type:Organization
Organization Name:ANCHORS OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOEHASS-IMEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LSCSW
Authorized Official - Phone:541-921-1504
Mailing Address - Street 1:PO BOX 821
Mailing Address - Street 2:
Mailing Address - City:NEOTSU
Mailing Address - State:OR
Mailing Address - Zip Code:97364-0821
Mailing Address - Country:US
Mailing Address - Phone:541-921-1504
Mailing Address - Fax:620-682-9840
Practice Address - Street 1:9252 S. SCHOONER CREEK RD
Practice Address - Street 2:
Practice Address - City:OTIS
Practice Address - State:OR
Practice Address - Zip Code:97368
Practice Address - Country:US
Practice Address - Phone:541-921-1504
Practice Address - Fax:620-682-9840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201271870AMedicaid
KS201271870AOtherKMAP
KS300046763635Medicaid