Provider Demographics
NPI:1952753170
Name:CHILDREN OF HOPE INC
Entity Type:Organization
Organization Name:CHILDREN OF HOPE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:MARCELA
Authorized Official - Last Name:WIRTH
Authorized Official - Suffix:
Authorized Official - Credentials:HM 60587680
Authorized Official - Phone:618-616-5623
Mailing Address - Street 1:3708 GOLDCREST HTS NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3708 GOLDCREST HTS NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4006
Practice Address - Country:US
Practice Address - Phone:618-616-5623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child