Healthcare Provider Details

I. General information

NPI: 1265644702
Provider Name (Legal Business Name): GOOD HOPE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 GOOD HOPE ROAD, SE
WASHINGTON DC
20020-6910
US

IV. Provider business mailing address

1320 GOOD HOPE ROAD, SE
WASHINGTON DC
20020-6910
US

V. Phone/Fax

Practice location:
  • Phone: 202-610-1886
  • Fax: 202-610-1887
Mailing address:
  • Phone: 202-610-1886
  • Fax: 202-610-1887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberSA0400055
License Number StateDC

VIII. Authorized Official

Name: MR. NEAL BERCH
Title or Position: EXECUTIVE DIRECTOR
Credential: BS
Phone: 202-610-1886