Provider Demographics
NPI:1932482221
Name:THE LIGHT OF HOPE COUNSELING CENTER INC
Entity Type:Organization
Organization Name:THE LIGHT OF HOPE COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BACA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-504-9798
Mailing Address - Street 1:366 RIVERSIDE DR
Mailing Address - Street 2:PO BOX 1419
Mailing Address - City:SUNLAND PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88063-9306
Mailing Address - Country:US
Mailing Address - Phone:915-504-9798
Mailing Address - Fax:915-858-4201
Practice Address - Street 1:366 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SUNLAND PARK
Practice Address - State:NM
Practice Address - Zip Code:88063-9306
Practice Address - Country:US
Practice Address - Phone:915-504-9798
Practice Address - Fax:915-858-4201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health