Provider Demographics
NPI:1790169522
Name:HOPES CENTER
Entity Type:Organization
Organization Name:HOPES CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBERAH
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-510-6084
Mailing Address - Street 1:1140 S 119TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-2135
Mailing Address - Country:US
Mailing Address - Phone:414-510-6084
Mailing Address - Fax:
Practice Address - Street 1:521 6TH ST
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1117
Practice Address - Country:US
Practice Address - Phone:262-898-2940
Practice Address - Fax:262-898-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4100-123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health