Healthcare Provider Details

I. General information

NPI: 1972274884
Provider Name (Legal Business Name): HOPE & HEALING MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 AMITY RD
CONWAY AR
72032-5991
US

IV. Provider business mailing address

775 AMITY RD
CONWAY AR
72032-5991
US

V. Phone/Fax

Practice location:
  • Phone: 501-504-6999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AHMED ABDELBASSET ALI
Title or Position: AO
Credential: MD
Phone: 917-370-1992