Healthcare Provider Details

I. General information

NPI: 1184289423
Provider Name (Legal Business Name): H.O.P.E. HELPING OTHERS PURSUE EXCELLENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HIGH ST
MOUNT HOLLY NJ
08060-1472
US

IV. Provider business mailing address

6 POPPYSEED DR
LUMBERTON NJ
08048-4266
US

V. Phone/Fax

Practice location:
  • Phone: 609-257-8008
  • Fax:
Mailing address:
  • Phone: 609-257-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. GWENDOLYN GOOLSBY - TILLERY
Title or Position: OWNER
Credential:
Phone: 609-257-8008