Provider Demographics
NPI:1881639714
Name:COMMUNITY OF HOPE, INC.
Entity Type:Organization
Organization Name:COMMUNITY OF HOPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-407-7747
Mailing Address - Street 1:4 ATLANTIC ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2350
Mailing Address - Country:US
Mailing Address - Phone:202-407-7747
Mailing Address - Fax:
Practice Address - Street 1:2155 CHAMPLAIN ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2795
Practice Address - Country:US
Practice Address - Phone:202-540-9857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC091819OtherMEDICARE GROUP NUMBER
P60683Medicare UPIN
G67657Medicare UPIN
B67424Medicare UPIN
DCF30407Medicare UPIN