Provider Demographics
NPI:1265237887
Name:HOPELIFE HOMECARE
Entity type:Organization
Organization Name:HOPELIFE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARAKA
Authorized Official - Middle Name:SIMON
Authorized Official - Last Name:CHEMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-848-3978
Mailing Address - Street 1:22802 27TH AVE S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-4403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22802 27TH AVE S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-4403
Practice Address - Country:US
Practice Address - Phone:507-848-3978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health