MEDICARE: HOPE ENACTED

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1518847185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE ENACTED

Provider Business Mailing Address
First Line	:	380 ALLEGHENY PL
Second Line	:
City	:	COLORADO SPGS
State	:	CO
Zip	:	80919-1119
Country	:	US
Telephone Number	:	845-490-8068
Fax Number	:

Provider Business Practice Location Address
First Line	:	380 ALLEGHENY PL
Second Line	:
City	:	COLORADO SPGS
State	:	CO
Zip	:	80919-1119
Country	:	US
Telephone Number	:	845-490-8068
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. NOAH ULLMAN
Credential	:
Telephone Number	:	845-490-8068

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/04/2025

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Directions to “HOPE ENACTED ” Practice Location

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