Provider Demographics
NPI:1760088629
Name:CHILD HOPE CENTER INC
Entity Type:Organization
Organization Name:CHILD HOPE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARBELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ TESCARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-843-7524
Mailing Address - Street 1:605 IVES DAIRY RD APT 303
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5440
Mailing Address - Country:US
Mailing Address - Phone:786-843-7524
Mailing Address - Fax:305-354-6152
Practice Address - Street 1:605 IVES DAIRY RD APT 303
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-5440
Practice Address - Country:US
Practice Address - Phone:786-843-7524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108869200Medicaid