Provider Demographics
NPI:1568602340
Name:LUCA'S HOPE
Entity Type:Organization
Organization Name:LUCA'S HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:BUTLER
Authorized Official - Last Name:STANBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-228-7309
Mailing Address - Street 1:7947 STILLWATER DR
Mailing Address - Street 2:
Mailing Address - City:SHERRILLS FORD
Mailing Address - State:NC
Mailing Address - Zip Code:28673-8325
Mailing Address - Country:US
Mailing Address - Phone:828-228-7309
Mailing Address - Fax:
Practice Address - Street 1:7947 STILLWATER DR
Practice Address - Street 2:
Practice Address - City:SHERRILLS FORD
Practice Address - State:NC
Practice Address - Zip Code:28673-8325
Practice Address - Country:US
Practice Address - Phone:828-478-2012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2018-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320800000X
NC018088322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children