Provider Demographics
NPI:1609167303
Name:HOPES, INC
Entity Type:Organization
Organization Name:HOPES, INC
Other - Org Name:HOPES RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ETHEL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-559-2551
Mailing Address - Street 1:5102 GAWAIN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2705
Mailing Address - Country:US
Mailing Address - Phone:210-559-2551
Mailing Address - Fax:210-251-4279
Practice Address - Street 1:5102 GAWAIN DR
Practice Address - Street 2:12521 NACOGDOCHES RD.
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-2705
Practice Address - Country:US
Practice Address - Phone:210-559-2551
Practice Address - Fax:210-251-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA0600X
TX127121320700000X
TX129087320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1609167303Medicaid
TX1609167303Medicare NSC