Provider Demographics
NPI:1629595889
Name:HOPE CHRISTIAN HEALTH CENTER CORP
Entity Type:Organization
Organization Name:HOPE CHRISTIAN HEALTH CENTER CORP
Other - Org Name:HOPE CHRISTIAN HEALTH CENTER MLK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-644-4673
Mailing Address - Street 1:4040 N MARTIN L KING BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-3205
Mailing Address - Country:US
Mailing Address - Phone:702-644-4673
Mailing Address - Fax:702-902-5443
Practice Address - Street 1:4040 N MARTIN LUTHER KING BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-644-4673
Practice Address - Fax:702-909-5143
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE CHRISTIAN HEALTH CENTER CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-28
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100545089Medicaid
1639540719OtherHOPE CHRISTIAN HEALTH CENTER NPI