Healthcare Provider Details

I. General information

NPI: 1598335242
Provider Name (Legal Business Name): HOPE IS HERE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16730 SCHOENBORN ST
NORTH HILLS CA
91343-6108
US

IV. Provider business mailing address

15571 LUCKY PL
SYLMAR CA
91342-3570
US

V. Phone/Fax

Practice location:
  • Phone: 323-385-4442
  • Fax:
Mailing address:
  • Phone: 323-385-4442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BOLAJI ADEDURO
Title or Position: PRESIDENT
Credential:
Phone: 323-385-4442