Provider Demographics
NPI:1013156447
Name:COLLABORATIVE HOPE
Entity Type:Organization
Organization Name:COLLABORATIVE HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGINS-WILKES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:704-496-9620
Mailing Address - Street 1:9700 RESEARCH DR STE 105
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8569
Mailing Address - Country:US
Mailing Address - Phone:704-496-9620
Mailing Address - Fax:
Practice Address - Street 1:9700 RESEARCH DR STE 105
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8569
Practice Address - Country:US
Practice Address - Phone:704-496-9620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health