Provider Demographics
NPI:1962045294
Name:HOUSE OF HOPE
Entity Type:Organization
Organization Name:HOUSE OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:SHANELL
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-990-0595
Mailing Address - Street 1:296 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:GA
Mailing Address - Zip Code:30817-4249
Mailing Address - Country:US
Mailing Address - Phone:706-990-0595
Mailing Address - Fax:706-990-0595
Practice Address - Street 1:296 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:GA
Practice Address - Zip Code:30817-4249
Practice Address - Country:US
Practice Address - Phone:706-990-0595
Practice Address - Fax:706-359-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health