Healthcare Provider Details
I. General information
NPI: 1689472532
Provider Name (Legal Business Name): HOPE 4 2MORROW LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7710 BALBOA AVE STE 204
SAN DIEGO CA
92111-2261
US
IV. Provider business mailing address
7710 BALBOA AVE STE 204
SAN DIEGO CA
92111-2261
US
V. Phone/Fax
- Phone: 614-266-1079
- Fax:
- Phone: 614-266-1079
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROGER
LEWIS
Title or Position: MANAGING MEMBER
Credential:
Phone: 614-266-1079