Healthcare Provider Details

I. General information

NPI: 1083414148
Provider Name (Legal Business Name): HOPE FOR COMMUNITIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E 20TH ST
FARMINGTON NM
87401-9022
US

IV. Provider business mailing address

59 ROAD 3785
FARMINGTON NM
87401-1039
US

V. Phone/Fax

Practice location:
  • Phone: 505-330-0869
  • Fax:
Mailing address:
  • Phone: 505-330-0869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH JOSLIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 505-330-0869