1184755647 NPI number — HOUSE OF HOPE

Table of content: (NPI 1184755647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184755647 NPI number — HOUSE OF HOPE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSE OF HOPE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOUSE OF HOPE
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184755647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2400 S GREENWICH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67210-1813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-265-6195
Provider Business Mailing Address Fax Number:
316-265-6199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2400 S GREENWICH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67210-1813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-265-6195
Provider Business Practice Location Address Fax Number:
316-265-6199
Provider Enumeration Date:
03/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
ALMA
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
316-265-6195

Provider Taxonomy Codes

  • Taxonomy code: 305R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)