Healthcare Provider Details

I. General information

NPI: 1164300752
Provider Name (Legal Business Name): HOPE BRIDGE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 W GLENDALE AVE STE B100
PHOENIX AZ
85051-8192
US

IV. Provider business mailing address

3507 W MCLELLAN BLVD
PHOENIX AZ
85019-1309
US

V. Phone/Fax

Practice location:
  • Phone: 623-313-3909
  • Fax:
Mailing address:
  • Phone: 623-313-3909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ENAS HAMID
Title or Position: CEO
Credential: BA
Phone: 623-313-3909