Provider Demographics
NPI:1932455359
Name:EARNEST MULLINS HOUSE OF HOPE: SHELTER FOR THE HOMELESS AND BATTERED W
Entity Type:Organization
Organization Name:EARNEST MULLINS HOUSE OF HOPE: SHELTER FOR THE HOMELESS AND BATTERED W
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:E
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-705-3203
Mailing Address - Street 1:164 SOUTH 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:BYESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43703
Mailing Address - Country:US
Mailing Address - Phone:740-509-1189
Mailing Address - Fax:
Practice Address - Street 1:164 S 2ND ST
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-1304
Practice Address - Country:US
Practice Address - Phone:740-509-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health