Provider Demographics
NPI:1811032303
Name:HOPE HOUSE, INC.
Entity Type:Organization
Organization Name:HOPE HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:O
Authorized Official - Last Name:CARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:706-737-9879
Mailing Address - Street 1:PO BOX 3597
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-3597
Mailing Address - Country:US
Mailing Address - Phone:706-737-9879
Mailing Address - Fax:706-737-9830
Practice Address - Street 1:2542 MILLEDGEVILLE RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-0407
Practice Address - Country:US
Practice Address - Phone:706-737-9879
Practice Address - Fax:706-737-9830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA121-524-D324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility