Healthcare Provider Details
I. General information
NPI: 1982932547
Provider Name (Legal Business Name): HANDS OF HOPE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4310 W UNIVERSITY BLVD
DURANT OK
74701-4577
US
IV. Provider business mailing address
4310 W UNIVERSITY BLVD
DURANT OK
74701-4577
US
V. Phone/Fax
- Phone: 580-924-6358
- Fax: 580-920-1901
- Phone: 580-924-6358
- Fax: 580-920-1901
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KIM
S
COOPER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 580-924-6358