Provider Demographics
NPI:1922738798
Name:HOPE CENTER FOR BEHAVIOR CHANGE, INC
Entity Type:Organization
Organization Name:HOPE CENTER FOR BEHAVIOR CHANGE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRIGHT-JOURDAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:561-843-2477
Mailing Address - Street 1:312 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3318
Mailing Address - Country:US
Mailing Address - Phone:561-843-2477
Mailing Address - Fax:
Practice Address - Street 1:2939 SOUTH CONGRESS AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406
Practice Address - Country:US
Practice Address - Phone:561-337-8865
Practice Address - Fax:773-337-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112770700Medicaid