Provider Demographics
NPI:1851022420
Name:WITH HOPE LLC
Entity Type:Organization
Organization Name:WITH HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:712-304-4249
Mailing Address - Street 1:114 N TRACY ST
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:IA
Mailing Address - Zip Code:50025-1247
Mailing Address - Country:US
Mailing Address - Phone:712-304-4249
Mailing Address - Fax:
Practice Address - Street 1:222 BROADWAY ST STE 2
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:IA
Practice Address - Zip Code:50025-1120
Practice Address - Country:US
Practice Address - Phone:855-563-6190
Practice Address - Fax:855-563-6192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center