Provider Demographics
NPI:1629515176
Name:THE HOPE SOURCE INC.
Entity Type:Organization
Organization Name:THE HOPE SOURCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-514-1838
Mailing Address - Street 1:5450 BOY SCOUT RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:IN
Mailing Address - Zip Code:46226-1317
Mailing Address - Country:US
Mailing Address - Phone:317-578-0410
Mailing Address - Fax:
Practice Address - Street 1:5450 BOY SCOUT RD
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:IN
Practice Address - Zip Code:46226-1317
Practice Address - Country:US
Practice Address - Phone:317-578-0410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty