Provider Demographics
NPI:1942991369
Name:ENGAGE HOPE
Entity Type:Organization
Organization Name:ENGAGE HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL / EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:GANN
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, MACMHC, LPC
Authorized Official - Phone:256-746-3626
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-0302
Mailing Address - Country:US
Mailing Address - Phone:256-746-3626
Mailing Address - Fax:
Practice Address - Street 1:15240 HWY 231 431 N
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750
Practice Address - Country:US
Practice Address - Phone:256-469-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)