Provider Demographics
NPI:1790467983
Name:HOPE HAVEN HOLISTIC TREATMENT SERVICES LLC
Entity Type:Organization
Organization Name:HOPE HAVEN HOLISTIC TREATMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:443-377-9660
Mailing Address - Street 1:2106 WALSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-1044
Mailing Address - Country:US
Mailing Address - Phone:443-377-9660
Mailing Address - Fax:
Practice Address - Street 1:8027 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-2627
Practice Address - Country:US
Practice Address - Phone:410-882-9000
Practice Address - Fax:410-882-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility