MEDICARE: HOPE STREET LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility
3	323P00000X	Psychiatric Residential Treatment Facility

General Provider Information

NPI Number	:	1790370203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE STREET LLC

Provider Business Mailing Address
First Line	:	1976 S LA CIENEGA BLVD STE 668
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-1627
Country	:	US
Telephone Number	:	310-721-6447
Fax Number	:

Provider Business Practice Location Address
First Line	:	2341 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6708
Country	:	US
Telephone Number	:	310-721-6447
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	ALAN BOND
Credential	:
Telephone Number	:	310-721-6447

Provider Enumeration Date	:	03/05/2021
Last Update Date	:	03/05/2021

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Directions to “HOPE STREET LLC ” Practice Location

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