Provider Demographics
NPI:1972848885
Name:HOPES FULFILLED LTD
Entity Type:Organization
Organization Name:HOPES FULFILLED LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-360-3377
Mailing Address - Street 1:220 STEEPLECHASE LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-2441
Mailing Address - Country:US
Mailing Address - Phone:513-360-3377
Mailing Address - Fax:513-360-3377
Practice Address - Street 1:220 STEEPLECHASE LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-2441
Practice Address - Country:US
Practice Address - Phone:513-360-3377
Practice Address - Fax:513-360-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0902054251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2892688Medicaid