1144917287 NPI number — HOPECOMING MENTAL HEALTH THERAPY SERVICES, A LCSW CORPORATION

Table of content: (NPI 1144917287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144917287 NPI number — HOPECOMING MENTAL HEALTH THERAPY SERVICES, A LCSW CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOPECOMING MENTAL HEALTH THERAPY SERVICES, A LCSW CORPORATION
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:
1144917287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1338 CENTER COURT DR STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COVINA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91724-3681
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-790-1801
Provider Business Mailing Address Fax Number:
626-380-0730

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1338 CENTER COURT DR STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91724-3681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-790-1801
Provider Business Practice Location Address Fax Number:
626-380-0730
Provider Enumeration Date:
04/19/2023

Additional Information

Authorized Official

Authorized Official Last Name:
TU
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
626-790-1801

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 106379 . This is a "BBS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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