Provider Demographics
NPI:1932592839
Name:FIELD OF HOPE COMMUNITY CAMPUS, INC.
Entity Type:Organization
Organization Name:FIELD OF HOPE COMMUNITY CAMPUS, INC.
Other - Org Name:FIELD OF HOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-245-3051
Mailing Address - Street 1:11821 STATE ROUTE 160
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:OH
Mailing Address - Zip Code:45686
Mailing Address - Country:US
Mailing Address - Phone:740-245-3051
Mailing Address - Fax:740-245-3052
Practice Address - Street 1:11821 STATE ROUTE 160
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:OH
Practice Address - Zip Code:45686
Practice Address - Country:US
Practice Address - Phone:740-245-3051
Practice Address - Fax:740-245-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0145313Medicaid