Provider Demographics
NPI:1295248466
Name:HOPE FAMILY CARE HOME LLC
Entity type:Organization
Organization Name:HOPE FAMILY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADDMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PINEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-842-7423
Mailing Address - Street 1:3634 CROSSWINDS DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2797
Mailing Address - Country:US
Mailing Address - Phone:858-842-7423
Mailing Address - Fax:
Practice Address - Street 1:3634 CROSSWINDS DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-2797
Practice Address - Country:US
Practice Address - Phone:858-842-7423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-026-067311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home