1710086822 NPI number — CHILDREN'S HOPE RESIDENTIAL SERVICES, INC.

Table of content: (NPI 1710086822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710086822 NPI number — CHILDREN'S HOPE RESIDENTIAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S HOPE RESIDENTIAL SERVICES, 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:
1710086822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 WEST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEVELLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79336-3341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-897-9735
Provider Business Mailing Address Fax Number:
806-568-0299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1313 W WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEVELLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79336-3921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-897-9735
Provider Business Practice Location Address Fax Number:
806-568-0299
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALDRICH
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
806-897-9735

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  823046 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , with the licence number: 823046 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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