Healthcare Provider Details

I. General information

NPI: 1063316768
Provider Name (Legal Business Name): HOPE SPRINGS RENEWAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 ROCKEFELLER CT UNIT 3
WALDORF MD
20602-2754
US

IV. Provider business mailing address

3434 ROCKEFELLER CT UNIT 3
WALDORF MD
20602-2754
US

V. Phone/Fax

Practice location:
  • Phone: 240-960-7515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. OLASUNKANMI P ATOKI
Title or Position: DIRECTOR
Credential: CPRP
Phone: 240-960-7515