Provider Demographics
NPI:1457916082
Name:COLOUR OF HOPE
Entity Type:Organization
Organization Name:COLOUR OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MONE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:949-607-8187
Mailing Address - Street 1:325 N MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-3428
Mailing Address - Country:US
Mailing Address - Phone:949-607-8187
Mailing Address - Fax:310-651-1999
Practice Address - Street 1:325 N MAPLE DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-3428
Practice Address - Country:US
Practice Address - Phone:949-607-8187
Practice Address - Fax:310-651-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA684862Medicaid