Healthcare Provider Details

I. General information

NPI: 1861981052
Provider Name (Legal Business Name): MISSION OF HOPE OF TALLAHASSEE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 GLENWAY DR
TALLAHASSEE FL
32301
US

IV. Provider business mailing address

1541 GLENWAY DR
TALLAHASSEE FL
32301
US

V. Phone/Fax

Practice location:
  • Phone: 850-322-4589
  • Fax: 229-236-0629
Mailing address:
  • Phone: 850-322-4589
  • Fax: 229-236-0629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: NANCY VICKERS-ADJEI
Title or Position: DIRECTOR
Credential:
Phone: 850-322-4589