Provider Demographics
NPI:1609058403
Name:HENDERSON'S HOUSE OF HOPE
Entity Type:Organization
Organization Name:HENDERSON'S HOUSE OF HOPE
Other - Org Name:GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-479-5073
Mailing Address - Street 1:5 OCEAN CT
Mailing Address - Street 2:DURHAM
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2287
Mailing Address - Country:US
Mailing Address - Phone:919-479-5073
Mailing Address - Fax:919-479-5073
Practice Address - Street 1:5 OCEAN CT
Practice Address - Street 2:DURHAM
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2287
Practice Address - Country:US
Practice Address - Phone:919-479-5073
Practice Address - Fax:919-479-5073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child