Provider Demographics
NPI:1265290126
Name:FOUNDATION OF HOPE INC
Entity type:Organization
Organization Name:FOUNDATION OF HOPE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIMALE
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-331-2274
Mailing Address - Street 1:1214 AUTUMN ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-6101
Mailing Address - Country:US
Mailing Address - Phone:763-331-2274
Mailing Address - Fax:
Practice Address - Street 1:1214 AUTUMN ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-6101
Practice Address - Country:US
Practice Address - Phone:763-331-2274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility