Provider Demographics
NPI:1639956774
Name:HOPE IN HEALING THERAPY, S.C.
Entity Type:Organization
Organization Name:HOPE IN HEALING THERAPY, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATKO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-277-4121
Mailing Address - Street 1:11869 GOLDEN GATE DR
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-2027
Mailing Address - Country:US
Mailing Address - Phone:708-277-4121
Mailing Address - Fax:
Practice Address - Street 1:11869 GOLDEN GATE DR
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-2027
Practice Address - Country:US
Practice Address - Phone:708-277-4121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health