Provider Demographics
NPI:1578238291
Name:HOPE 4HAVEN, LLC
Entity Type:Organization
Organization Name:HOPE 4HAVEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIAWON
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-698-0112
Mailing Address - Street 1:4031 SWEETWATER PKWY
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-1576
Mailing Address - Country:US
Mailing Address - Phone:678-698-0112
Mailing Address - Fax:866-654-6692
Practice Address - Street 1:4031 SWEETWATER PKWY
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-1576
Practice Address - Country:US
Practice Address - Phone:678-698-0112
Practice Address - Fax:866-654-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care