Provider Demographics
NPI:1851064034
Name:HOPE MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:HOPE MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCH NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:541-624-3117
Mailing Address - Street 1:PO BOX 614
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OR
Mailing Address - Zip Code:97827-0614
Mailing Address - Country:US
Mailing Address - Phone:541-624-3117
Mailing Address - Fax:541-605-5361
Practice Address - Street 1:870 ALDER STREET
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:OR
Practice Address - Zip Code:97827
Practice Address - Country:US
Practice Address - Phone:541-624-3117
Practice Address - Fax:541-605-5361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)