Healthcare Provider Details

I. General information

NPI: 1033648613
Provider Name (Legal Business Name): WINDOWS OF HOPE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 STONEBRIDGE DR
ORANGE PARK FL
32065-5769
US

IV. Provider business mailing address

2304 STONEBRIDGE DR
ORANGE PARK FL
32065-5769
US

V. Phone/Fax

Practice location:
  • Phone: 386-795-6185
  • Fax:
Mailing address:
  • Phone: 386-795-6185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: SUSAN BAUGHMAN
Title or Position: DIRECTOR OF DEVELOPMENT
Credential:
Phone: 386-795-6185