Healthcare Provider Details

I. General information

NPI: 1275800914
Provider Name (Legal Business Name): COMMUNITY OF HOPE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3845 S CAPITOL ST SW
WASHINGTON DC
20032-1419
US

IV. Provider business mailing address

1717 MASSACHUSETTS AVE NW SUITE 805
WASHINGTON DC
20036-2001
US

V. Phone/Fax

Practice location:
  • Phone: 202-407-7747
  • Fax:
Mailing address:
  • Phone: 202-407-7747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLY SWEENEY MCSHANE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 202-407-7746