Healthcare Provider Details

I. General information

NPI: 1144616111
Provider Name (Legal Business Name): HOPE ADVANCEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 FAIRVIEW RD SUITE 290
CHARLOTTE NC
28210-3258
US

IV. Provider business mailing address

6230 FAIRVIEW RD SUITE 290
CHARLOTTE NC
28210-3258
US

V. Phone/Fax

Practice location:
  • Phone: 704-956-3062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEMETRIUS CRAYTON
Title or Position: CEO
Credential:
Phone: 704-956-3062