Provider Demographics
NPI:1700403789
Name:PROVIDING HOPE PSYCHIATRIC REHABILITATION PROGRAM
Entity Type:Organization
Organization Name:PROVIDING HOPE PSYCHIATRIC REHABILITATION PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-698-8442
Mailing Address - Street 1:1420 MERRITT BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-2192
Mailing Address - Country:US
Mailing Address - Phone:410-698-8442
Mailing Address - Fax:
Practice Address - Street 1:1420 MERRITT BLVD STE B
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-2192
Practice Address - Country:US
Practice Address - Phone:410-698-8442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE AGAIN COUNSELING SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)