Provider Demographics
NPI:1962028076
Name:HOPE HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:HOPE HEALTH SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLANRELE
Authorized Official - Middle Name:OLADIPO
Authorized Official - Last Name:FADIORA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:443-865-7549
Mailing Address - Street 1:PO BOX 47518
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-0518
Mailing Address - Country:US
Mailing Address - Phone:443-865-7549
Mailing Address - Fax:
Practice Address - Street 1:6210 GEORGETOWN BLVD STE ABC
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6418
Practice Address - Country:US
Practice Address - Phone:410-216-6418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE HEALTH SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD222000800Medicaid