Provider Demographics
NPI:1639816796
Name:HOUSE OF HOPE
Entity Type:Organization
Organization Name:HOUSE OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEBANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-534-5410
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-0002
Mailing Address - Country:US
Mailing Address - Phone:336-534-5410
Mailing Address - Fax:336-652-8023
Practice Address - Street 1:412 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5934
Practice Address - Country:US
Practice Address - Phone:336-534-5410
Practice Address - Fax:336-652-8023
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSE OF HOPE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities