Provider Demographics
NPI:1184084949
Name:HOPEWELL GROUP HOUSING
Entity type:Organization
Organization Name:HOPEWELL GROUP HOUSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:O
Authorized Official - Last Name:IJIEWERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-510-8090
Mailing Address - Street 1:2008 W FARWELL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4923
Mailing Address - Country:US
Mailing Address - Phone:773-510-8090
Mailing Address - Fax:
Practice Address - Street 1:2008 W FARWELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4923
Practice Address - Country:US
Practice Address - Phone:773-510-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
ILNONE103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty