Provider Demographics
NPI:1265887277
Name:RESOURCE RAE OF HOPE, LLC
Entity type:Organization
Organization Name:RESOURCE RAE OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:DEPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:CASAC
Authorized Official - Phone:929-295-2093
Mailing Address - Street 1:449 39TH ST
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2909
Mailing Address - Country:US
Mailing Address - Phone:929-295-2093
Mailing Address - Fax:
Practice Address - Street 1:449 39TH ST
Practice Address - Street 2:FLOOR 3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2909
Practice Address - Country:US
Practice Address - Phone:929-295-2093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility