Provider Demographics
NPI:1669995221
Name:EMERGING HOPE FAMILY STRENGTHENING PROGRAM
Entity type:Organization
Organization Name:EMERGING HOPE FAMILY STRENGTHENING PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW, MDIV, DMIN
Authorized Official - Phone:269-205-3356
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49081-0224
Mailing Address - Country:US
Mailing Address - Phone:269-205-3356
Mailing Address - Fax:
Practice Address - Street 1:3825 EMERALD DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-7919
Practice Address - Country:US
Practice Address - Phone:269-205-3356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801091924261QM0850X, 261QM0855X, 251B00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801091924OtherLIMITED MASTER'S SOCIAL WORKER