Healthcare Provider Details

I. General information

NPI: 1013147974
Provider Name (Legal Business Name): TIERS OF HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2009
Last Update Date: 07/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 HURRICANE CREEK RD
HYDEN KY
41749-8672
US

IV. Provider business mailing address

874 HURRICANE CREEK RD
HYDEN KY
41749-8672
US

V. Phone/Fax

Practice location:
  • Phone: 606-216-7851
  • Fax:
Mailing address:
  • Phone: 606-216-7851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHIRLEY FAYE MAGGARD
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 606-216-7851