Provider Demographics
NPI:1619666021
Name:HOPEWAY FOUNDATION
Entity Type:Organization
Organization Name:HOPEWAY FOUNDATION
Other - Org Name:HOPEWAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:R
Authorized Official - Last Name:KUROSKI-MAZZEI
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MRO, DFAPA, FASA
Authorized Official - Phone:980-859-2106
Mailing Address - Street 1:1717 SHARON RD W
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-5663
Mailing Address - Country:US
Mailing Address - Phone:980-859-2106
Mailing Address - Fax:
Practice Address - Street 1:4014 MONROE ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-7706
Practice Address - Country:US
Practice Address - Phone:980-859-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)