Provider Demographics
NPI:1740478767
Name:HOPE, INC
Entity type:Organization
Organization Name:HOPE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:PRITCHARD
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:DMIN
Authorized Official - Phone:937-268-2663
Mailing Address - Street 1:4641 HOOVER AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-1121
Mailing Address - Country:US
Mailing Address - Phone:937-268-2663
Mailing Address - Fax:937-268-2219
Practice Address - Street 1:4641 HOOVER AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-1121
Practice Address - Country:US
Practice Address - Phone:937-268-2663
Practice Address - Fax:937-268-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL90474302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization