Provider Demographics
NPI:1578696290
Name:HOPE D. MULLIS
Entity Type:Organization
Organization Name:HOPE D. MULLIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MULLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-454-6384
Mailing Address - Street 1:188 LAKEPORT RD
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7728
Mailing Address - Country:US
Mailing Address - Phone:478-454-6384
Mailing Address - Fax:478-452-6212
Practice Address - Street 1:188 LAKEPORT RD
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-7728
Practice Address - Country:US
Practice Address - Phone:478-454-6384
Practice Address - Fax:478-452-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare