Provider Demographics
NPI:1689048985
Name:HOPE RENEWED COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:HOPE RENEWED COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-501-8844
Mailing Address - Street 1:1810 SUNRISE CT
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-1971
Mailing Address - Country:US
Mailing Address - Phone:608-501-8844
Mailing Address - Fax:608-960-4630
Practice Address - Street 1:6000 GISHOLT DR STE 202
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-4816
Practice Address - Country:US
Practice Address - Phone:608-406-2624
Practice Address - Fax:608-960-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)