Provider Demographics
NPI:1013474113
Name:HOPE HOUSE ON CROTONA PARK, LLC
Entity Type:Organization
Organization Name:HOPE HOUSE ON CROTONA PARK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:518-929-0631
Mailing Address - Street 1:55 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:853 CROTONA PARK N
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4701
Practice Address - Country:US
Practice Address - Phone:518-929-0631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENBURGER CENTER FOR SOCIAL AND CRIMINAL JUSITCE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness