Healthcare Provider Details

I. General information

NPI: 1225726086
Provider Name (Legal Business Name): HOPE RECOVERY KOKOMO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 E 100 N
KOKOMO IN
46901-3459
US

IV. Provider business mailing address

6060 W MANCHESTER AVE STE 304
LOS ANGELES CA
90045-4267
US

V. Phone/Fax

Practice location:
  • Phone: 765-780-7689
  • Fax:
Mailing address:
  • Phone: 909-263-4829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: NICK SALVATO
Title or Position: CEO
Credential:
Phone: 765-780-7689