Healthcare Provider Details

I. General information

NPI: 1154010742
Provider Name (Legal Business Name): HOPE ENACTED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 ALLEGHENY PL
COLORADO SPRINGS CO
80919-1119
US

IV. Provider business mailing address

380 ALLEGHENY PL
COLORADO SPRINGS CO
80919-1119
US

V. Phone/Fax

Practice location:
  • Phone: 845-490-8068
  • Fax:
Mailing address:
  • Phone: 845-490-8068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: NOAH ULLMAN
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 845-490-8068