Healthcare Provider Details

I. General information

NPI: 1699100941
Provider Name (Legal Business Name): HOPE HEALTH AND HEALING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 SCENIC HWY S
SNELLVILLE GA
30078-3115
US

IV. Provider business mailing address

2330 SCENIC HWY S
SNELLVILLE GA
30078-3115
US

V. Phone/Fax

Practice location:
  • Phone: 404-492-7015
  • Fax: 404-492-7017
Mailing address:
  • Phone: 404-492-7015
  • Fax: 404-492-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLPC007338
License Number StateGA

VIII. Authorized Official

Name: MIKO JONES
Title or Position: OWNER/DIRECTOR
Credential: LPC, NCC, ACS
Phone: 404-492-7015