Healthcare Provider Details

I. General information

NPI: 1710707120
Provider Name (Legal Business Name): HOPEWAY COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 PATRICIA LN
MANCHESTER NH
03104-2865
US

IV. Provider business mailing address

122 PATRICIA LN
MANCHESTER NH
03104-2865
US

V. Phone/Fax

Practice location:
  • Phone: 513-913-7057
  • Fax:
Mailing address:
  • Phone: 513-913-7057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. BIBEK SINGH
Title or Position: OWNER
Credential:
Phone: 513-913-7057