Healthcare Provider Details

I. General information

NPI: 1750053518
Provider Name (Legal Business Name): HOPE AGING CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 MONTE VISTA AVE
COSTA MESA CA
92627-5149
US

IV. Provider business mailing address

1048 IRVINE AVE # 840
NEWPORT BEACH CA
92660-4602
US

V. Phone/Fax

Practice location:
  • Phone: 949-836-2812
  • Fax:
Mailing address:
  • Phone: 949-836-2812
  • Fax: 949-209-2612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNA MAURIZI
Title or Position: CARE MANAGER
Credential:
Phone: 949-836-2812