Provider Demographics
NPI:1619194172
Name:HOUSE OF HOPE OF MADISON COUNTY, INC.
Entity Type:Organization
Organization Name:HOUSE OF HOPE OF MADISON COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOOG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:765-644-7086
Mailing Address - Street 1:902 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-3025
Mailing Address - Country:US
Mailing Address - Phone:765-644-7086
Mailing Address - Fax:
Practice Address - Street 1:902 HIGH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-3025
Practice Address - Country:US
Practice Address - Phone:765-644-7086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility