Provider Demographics
NPI:1629198312
Name:HOPE PSYCHIATRIC PLLC
Entity Type:Organization
Organization Name:HOPE PSYCHIATRIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUBHASH
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-854-9595
Mailing Address - Street 1:432 E LONG AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2500
Mailing Address - Country:US
Mailing Address - Phone:704-854-9595
Mailing Address - Fax:704-852-4488
Practice Address - Street 1:432 E LONG AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2500
Practice Address - Country:US
Practice Address - Phone:704-854-9595
Practice Address - Fax:704-852-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701100261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891121JMedicaid
NC891121JMedicaid