Provider Demographics
NPI:1952160152
Name:HOPEFUL PSYCHIATRIC SERVICES LLC
Entity Type:Organization
Organization Name:HOPEFUL PSYCHIATRIC SERVICES LLC
Other - Org Name:HOPEFUL PSYCHIATRY SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STELLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KULABAKO
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:617-543-2611
Mailing Address - Street 1:1 OLSON ST UNIT 13
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-2458
Mailing Address - Country:US
Mailing Address - Phone:617-543-2611
Mailing Address - Fax:
Practice Address - Street 1:1 OLSON ST UNIT 13
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2458
Practice Address - Country:US
Practice Address - Phone:617-543-2611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty