Provider Demographics
NPI:1891469425
Name:HOPE IN HEALING LLC
Entity Type:Organization
Organization Name:HOPE IN HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:863-258-6954
Mailing Address - Street 1:4100 SPIRIT LAKE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-5081
Mailing Address - Country:US
Mailing Address - Phone:863-258-6954
Mailing Address - Fax:863-269-0246
Practice Address - Street 1:4100 SPIRIT LAKE RD STE 4
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-5081
Practice Address - Country:US
Practice Address - Phone:863-258-6954
Practice Address - Fax:863-269-0246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108401700Medicaid