Provider Demographics
NPI:1457596389
Name:HOPE INTERNATIONAL HEALTH & SOCIAL SERVICES, INC.
Entity Type:Organization
Organization Name:HOPE INTERNATIONAL HEALTH & SOCIAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WALAKAWON
Authorized Official - Last Name:GBALA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS
Authorized Official - Phone:651-771-8821
Mailing Address - Street 1:1526 6TH ST E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-4806
Mailing Address - Country:US
Mailing Address - Phone:651-771-8821
Mailing Address - Fax:651-771-3222
Practice Address - Street 1:1526 6TH ST E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-4806
Practice Address - Country:US
Practice Address - Phone:651-771-8821
Practice Address - Fax:651-771-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
MN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health