1609952373 NPI number — HOUSE OF HOPE, INC.

Table of content: (NPI 1609952373)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609952373 NPI number — HOUSE OF HOPE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOUSE OF HOPE, INC.
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:
Provider Other Organization Name Type Code:
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:
1609952373
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 291
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANKATO
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56002-0291
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-385-7600
Provider Business Mailing Address Fax Number:
507-720-6929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1429 3RD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANKATO
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56001-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-625-4536
Provider Business Practice Location Address Fax Number:
507-625-4536
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KREUTZER
Authorized Official First Name:
ARLENE
Authorized Official Middle Name:
DORIS-MANTHY
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT, FINANCE
Authorized Official Telephone Number:
507-385-7600

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  801093-2-CDT , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1609952373 . This is a "NPI # RESIDENTIAL" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 265856900 . This is a "MHCP PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8107HO . This is a "BC/BS CONTRACT PROV NUM" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com