MEDICARE: HOUSE OF HOPE

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	343900000X	Non-emergency Medical Transport (VAN)	ALH-2895	AZ

General Provider Information

NPI Number	:	1174667125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSE OF HOPE

Provider Business Mailing Address
First Line	:	424 W KAIBAB WAY
Second Line	:
City	:	COCHISE
State	:	AZ
Zip	:	85606-8710
Country	:	US
Telephone Number	:	520-826-4065
Fax Number	:	520-826-1716

Provider Business Practice Location Address
First Line	:	424 W KAIBAB WAY
Second Line	:
City	:	COCHISE
State	:	AZ
Zip	:	85606-8710
Country	:	US
Telephone Number	:	520-826-4065
Fax Number	:	520-826-1716

Authorized Official
Title or Position	:	MANAGER OWNER
Name	:	MRS. BARBARA ANN HART
Credential	:	LICENSE PRACTICALNUR
Telephone Number	:	520-826-4065

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	06/24/2008

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Directions to “HOUSE OF HOPE ” Practice Location

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