Provider Demographics
NPI:1245908987
Name:HOPE COMMUNITY WELLNESS CENTER CORP
Entity type:Organization
Organization Name:HOPE COMMUNITY WELLNESS CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:NAPOLES PAJON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:867-233-9190
Mailing Address - Street 1:876 W SUGARLAND HWY UNIT C
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-2704
Mailing Address - Country:US
Mailing Address - Phone:867-233-9190
Mailing Address - Fax:
Practice Address - Street 1:876 W SUGARLAND HWY UNIT C
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-2704
Practice Address - Country:US
Practice Address - Phone:867-233-9190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty