Provider Demographics
NPI:1619414604
Name:HOPE HEALTH CLINIC
Entity Type:Organization
Organization Name:HOPE HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-225-6711
Mailing Address - Street 1:1025 SANIBEL WAY STE E
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-9156
Mailing Address - Country:US
Mailing Address - Phone:502-225-6711
Mailing Address - Fax:502-225-6757
Practice Address - Street 1:1025 SANIBEL WAY STE E
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9156
Practice Address - Country:US
Practice Address - Phone:502-225-6711
Practice Address - Fax:502-225-6757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY740253261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service