Provider Demographics
NPI:1669635199
Name:HOPE THERAPY CENTER, LLC
Entity type:Organization
Organization Name:HOPE THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:337-478-5880
Mailing Address - Street 1:1717 E PRIEN LAKE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-0400
Mailing Address - Country:US
Mailing Address - Phone:337-478-5880
Mailing Address - Fax:337-478-5879
Practice Address - Street 1:1717 E PRIEN LAKE RD STE 1
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-0400
Practice Address - Country:US
Practice Address - Phone:337-478-5880
Practice Address - Fax:337-478-5879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3B103Medicare PIN
LA5DF17Medicare PIN
LA3B853Medicare PIN
LA4C591Medicare PIN
LA3B851Medicare PIN
LA4C489Medicare PIN
LA3B451Medicare PIN