MEDICARE: HOPE CENTER OUTPATIENT SERVICES LLC

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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1154277960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE CENTER OUTPATIENT SERVICES LLC

Provider Business Mailing Address
First Line	:	113 E OAK ST
Second Line	:
City	:	SELMA
State	:	NC
Zip	:	27576-2845
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	113 E OAK ST
Second Line	:
City	:	SELMA
State	:	NC
Zip	:	27576-2845
Country	:	US
Telephone Number	:	615-854-5228
Fax Number	:

Authorized Official
Title or Position	:	NATIONAL DIRECTOR
Name	:	STEPHEN PALK
Credential	:
Telephone Number	:	615-854-5228

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “HOPE CENTER OUTPATIENT SERVICES LLC ” Practice Location

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