Provider Demographics
NPI:1689928772
Name:HOPE HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:HOPE HEALTH SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:OLANRELE
Authorized Official - Middle Name:
Authorized Official - Last Name:FADIORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-663-4400
Mailing Address - Street 1:6707 WHITESTONE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WOODLAWN
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4106
Mailing Address - Country:US
Mailing Address - Phone:410-944-4673
Mailing Address - Fax:
Practice Address - Street 1:1726 WHITEHEAD RD OFC
Practice Address - Street 2:
Practice Address - City:WOODLAWN
Practice Address - State:MD
Practice Address - Zip Code:21207-4003
Practice Address - Country:US
Practice Address - Phone:443-865-7549
Practice Address - Fax:410-265-1258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-29
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12111251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD222000800Medicaid