Healthcare Provider Details

I. General information

NPI: 1235470055
Provider Name (Legal Business Name): H O P E PREVENTION AWARENESS & MENTORING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2013
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 LINCOLN RD SUITE B
HATTIESBURG MS
39402-3226
US

IV. Provider business mailing address

1707 LINCOLN RD SUITE B
HATTIESBURG MS
39402-3226
US

V. Phone/Fax

Practice location:
  • Phone: 601-212-9707
  • Fax: 601-336-7395
Mailing address:
  • Phone: 601-212-9707
  • Fax: 601-336-7395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. HOPE ALYSIA GRIFFITH-JONES
Title or Position: CEO
Credential: M.S. , PCMHT, PCAT
Phone: 601-212-9707