Healthcare Provider Details
I. General information
NPI: 1982880175
Provider Name (Legal Business Name): HOPE RESTORED HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2008
Last Update Date: 07/21/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 ELIOT CIR
MILTON MA
02186-1601
US
IV. Provider business mailing address
1 ELIOT CIR
MILTON MA
02186-1601
US
V. Phone/Fax
- Phone: 617-698-1740
- Fax: 617-698-4531
- Phone: 617-698-1740
- Fax: 617-698-4531
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 302R00000X |
| Taxonomy | Health Maintenance Organization |
| License Number | |
| License Number State | MA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | MA |
VIII. Authorized Official
Name: MRS.
PATRICIA
O.
BABAJIDE
Title or Position: C.E.O.
Credential:
Phone: 617-698-1740