Provider Demographics
NPI:1609422237
Name:PLACE OF HOPE INC
Entity Type:Organization
Organization Name:PLACE OF HOPE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUGUNWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-259-0780
Mailing Address - Street 1:5405 JONESBORO RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30260-3504
Mailing Address - Country:US
Mailing Address - Phone:404-259-0780
Mailing Address - Fax:404-608-9719
Practice Address - Street 1:5405 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:GA
Practice Address - Zip Code:30260-3504
Practice Address - Country:US
Practice Address - Phone:404-259-0780
Practice Address - Fax:404-608-9719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center