Provider Demographics
NPI:1790294841
Name:THE HOPE ROOM, LLC
Entity Type:Organization
Organization Name:THE HOPE ROOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-788-1072
Mailing Address - Street 1:12703 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-2425
Mailing Address - Country:US
Mailing Address - Phone:404-788-1072
Mailing Address - Fax:
Practice Address - Street 1:20 W 9TH ST STE 601
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64105-1704
Practice Address - Country:US
Practice Address - Phone:404-788-1072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017009375101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty