Healthcare Provider Details

I. General information

NPI: 1013780600
Provider Name (Legal Business Name): HOPE ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9332 OLD SCAGGSVILLE RD
LAUREL MD
20723-1732
US

IV. Provider business mailing address

9332 OLD SCAGGSVILLE RD
LAUREL MD
20723-1732
US

V. Phone/Fax

Practice location:
  • Phone: 301-490-2347
  • Fax:
Mailing address:
  • Phone: 301-490-2347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: MRS. VICTORIA INCOOM
Title or Position: CEO
Credential: RN
Phone: 301-490-2347