Provider Demographics
NPI:1659663755
Name:HOPE ADULT DAY CENTER
Entity Type:Organization
Organization Name:HOPE ADULT DAY CENTER
Other - Org Name:NA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:210-454-3720
Mailing Address - Street 1:2800 NE LOOP 410 STE 305
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-1525
Mailing Address - Country:US
Mailing Address - Phone:210-454-3720
Mailing Address - Fax:
Practice Address - Street 1:2800 NE LOOP 410 STE 305
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-1525
Practice Address - Country:US
Practice Address - Phone:210-454-3720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care