Healthcare Provider Details

I. General information

NPI: 1447606462
Provider Name (Legal Business Name): COMMUNITY OF HOPE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 GIRARD ST NW
WASHINGTON DC
20009-4611
US

IV. Provider business mailing address

4 ATLANTIC ST SW
WASHINGTON DC
20032-2350
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: DEREK SYKES
Title or Position: VP OF FINANCE AND OPERATIONS
Credential:
Phone: 202-407-7747