Provider Demographics
NPI:1790210862
Name:HOPE IN CRISIS LLC
Entity Type:Organization
Organization Name:HOPE IN CRISIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MUCCINO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:732-230-2570
Mailing Address - Street 1:1001 FISCHER BLVD
Mailing Address - Street 2:#124
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3818
Mailing Address - Country:US
Mailing Address - Phone:908-783-3911
Mailing Address - Fax:732-328-2718
Practice Address - Street 1:814 FISCHER BLVD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-4680
Practice Address - Country:US
Practice Address - Phone:732-230-2570
Practice Address - Fax:732-800-4543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00452900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty