Provider Demographics
NPI:1871007435
Name:HOPE DRUG REHABILITATION CENTER LLP
Entity Type:Organization
Organization Name:HOPE DRUG REHABILITATION CENTER LLP
Other - Org Name:HOPE DRUG REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:EYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-881-7928
Mailing Address - Street 1:5314 STEPHEN WAY
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1159
Mailing Address - Country:US
Mailing Address - Phone:304-881-7928
Mailing Address - Fax:
Practice Address - Street 1:5257 BIG TYLER RD
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1839
Practice Address - Country:US
Practice Address - Phone:304-881-7928
Practice Address - Fax:304-881-7928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-18
Last Update Date:2017-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility