Provider Demographics
NPI:1669811451
Name:HOPE VILLAGE FOR CHILDREN, INC.
Entity type:Organization
Organization Name:HOPE VILLAGE FOR CHILDREN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-553-8660
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-0026
Mailing Address - Country:US
Mailing Address - Phone:601-553-8660
Mailing Address - Fax:601-553-8669
Practice Address - Street 1:2433 23RD AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-2156
Practice Address - Country:US
Practice Address - Phone:601-553-8660
Practice Address - Fax:601-553-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSHVCBCSCOMLIV01253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency