Provider Demographics
NPI:1922496223
Name:HOPE RECOVERY CENTER
Entity Type:Organization
Organization Name:HOPE RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-883-1454
Mailing Address - Street 1:9300 SHELBYVILLE RD STE 506
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5164
Mailing Address - Country:US
Mailing Address - Phone:502-883-1454
Mailing Address - Fax:502-883-1456
Practice Address - Street 1:9300 SHELBYVILLE RD STE 506
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5164
Practice Address - Country:US
Practice Address - Phone:502-883-1454
Practice Address - Fax:502-883-1456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty