Provider Demographics
NPI:1851797641
Name:HOPE HEALTHCARE STAFFING AGEN CY
Entity Type:Organization
Organization Name:HOPE HEALTHCARE STAFFING AGEN CY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:MASSA
Authorized Official - Last Name:BRASEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:601-260-4190
Mailing Address - Street 1:1074 BEALL RD
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:MS
Mailing Address - Zip Code:39083-9420
Mailing Address - Country:US
Mailing Address - Phone:601-260-4190
Mailing Address - Fax:601-894-1670
Practice Address - Street 1:1074 BEALL RD
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:MS
Practice Address - Zip Code:39083-9420
Practice Address - Country:US
Practice Address - Phone:601-260-4190
Practice Address - Fax:601-894-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR865620253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care