Provider Demographics
NPI:1770979601
Name:HOPE HEALTH CARE, INC.
Entity type:Organization
Organization Name:HOPE HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:O
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-328-4819
Mailing Address - Street 1:4721 HIAWATHA AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3928
Mailing Address - Country:US
Mailing Address - Phone:612-328-4819
Mailing Address - Fax:
Practice Address - Street 1:4721 HIAWATHA AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3928
Practice Address - Country:US
Practice Address - Phone:612-328-4819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1074667101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1780851402Medicaid
MN1760707285Medicaid