Provider Demographics
NPI:1679360457
Name:HOPE HARBOR FCH LLC
Entity type:Organization
Organization Name:HOPE HARBOR FCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:TYRIK
Authorized Official - Middle Name:KAWAN
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-612-3565
Mailing Address - Street 1:8625 NC HIGHWAY 49 N
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:NC
Mailing Address - Zip Code:28124-9431
Mailing Address - Country:US
Mailing Address - Phone:704-612-3565
Mailing Address - Fax:
Practice Address - Street 1:8625 NC HIGHWAY 49 N
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:NC
Practice Address - Zip Code:28124-9431
Practice Address - Country:US
Practice Address - Phone:704-612-3565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities