Provider Demographics
NPI:1598053720
Name:PROVIDING HOPE
Entity Type:Organization
Organization Name:PROVIDING HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FREDERICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-327-7331
Mailing Address - Street 1:1425 CRICKET RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-2969
Mailing Address - Country:US
Mailing Address - Phone:919-327-7331
Mailing Address - Fax:866-593-1799
Practice Address - Street 1:1425 CRICKET RIDGE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-2969
Practice Address - Country:US
Practice Address - Phone:919-327-7331
Practice Address - Fax:866-593-1799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health