Provider Demographics
NPI:1811125669
Name:HOPE HOUSE RESTORATION CENTER
Entity type:Organization
Organization Name:HOPE HOUSE RESTORATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BECTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-965-8404
Mailing Address - Street 1:4102 CORNERROCK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8586
Mailing Address - Country:US
Mailing Address - Phone:336-697-8451
Mailing Address - Fax:336-697-7939
Practice Address - Street 1:4102 CORNERROCK DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8586
Practice Address - Country:US
Practice Address - Phone:336-697-8451
Practice Address - Fax:336-697-7939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC041916322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children