Provider Demographics
NPI:1356773618
Name:PORT OF HOPE CENTERS, INC
Entity type:Organization
Organization Name:PORT OF HOPE CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:HOGAN
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:CADC/CCS
Authorized Official - Phone:208-463-0118
Mailing Address - Street 1:508 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5823
Mailing Address - Country:US
Mailing Address - Phone:208-463-0118
Mailing Address - Fax:208-463-1507
Practice Address - Street 1:508 E FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5823
Practice Address - Country:US
Practice Address - Phone:208-463-0118
Practice Address - Fax:208-463-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty