Provider Demographics
NPI:1710020128
Name:HOPE OF SAMPSON COUNTY
Entity Type:Organization
Organization Name:HOPE OF SAMPSON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:910-590-0010
Mailing Address - Street 1:51 ROWAN RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-4786
Mailing Address - Country:US
Mailing Address - Phone:910-590-0010
Mailing Address - Fax:910-590-0041
Practice Address - Street 1:51 ROWAN RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4786
Practice Address - Country:US
Practice Address - Phone:910-590-0010
Practice Address - Fax:910-590-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301298JMedicaid
NC8301298Medicaid
NC8301298BMedicaid
NC8301298GMedicaid