Healthcare Provider Details

I. General information

NPI: 1700961836
Provider Name (Legal Business Name): HOPE UNLIMITED FAMILY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 JEFFERSON ST
PADUCAH KY
42001-1835
US

IV. Provider business mailing address

1101 JEFFERSON ST P.O. BOX 7403
PADUCAH KY
42001-1835
US

V. Phone/Fax

Practice location:
  • Phone: 270-442-1166
  • Fax: 270-442-9948
Mailing address:
  • Phone: 270-442-1166
  • Fax: 270-442-9948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number1046053
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE S. GREEN
Title or Position: SONOGRAPHER
Credential: RDMS
Phone: 270-442-1166