Healthcare Provider Details

I. General information

NPI: 1184589525
Provider Name (Legal Business Name): HOPE HAVEN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 N TRYON ST
CHARLOTTE NC
28206-2060
US

IV. Provider business mailing address

3815 N TRYON ST
CHARLOTTE NC
28206-2060
US

V. Phone/Fax

Practice location:
  • Phone: 704-372-8809
  • Fax:
Mailing address:
  • Phone: 704-372-8809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: EBONY COPELAND
Title or Position: DIRECTOR OF WFDH
Credential:
Phone: 704-963-7762