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NPI Code Detail

MEDICARE: THE HOPE SOURCE

MEDICARE: THE HOPE SOURCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1053846733
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE HOPE SOURCE
Provider Business Mailing Address
First Line : 8350 CRAIG ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3593
Country : US
Telephone Number : 317-517-8817
Fax Number : 317-436-7409
Provider Business Practice Location Address
First Line : 8350 CRAIG ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3593
Country : US
Telephone Number : 317-578-0410
Fax Number : 317-436-7409
Authorized Official
Title or Position : EXECUTIVE CLINICAL DIRECTOR
Name : DR. MOMI YAMANAKA
Credential : PH.D. HSPP
Telephone Number : 317-517-8817
Provider Enumeration Date : 05/01/2017
Last Update Date : 12/04/2024

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Directions to “THE HOPE SOURCE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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