Healthcare Provider Details

I. General information

NPI: 1629268404
Provider Name (Legal Business Name): HOPE COUNSELING SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 HIGHLINE BLVD SUITE 204
OKLAHOMA CITY OK
73108-1865
US

IV. Provider business mailing address

4411 HIGHLINE BLVD SUITE 204
OKLAHOMA CITY OK
73108-1865
US

V. Phone/Fax

Practice location:
  • Phone: 405-942-4740
  • Fax: 405-942-4742
Mailing address:
  • Phone: 405-942-4740
  • Fax: 405-942-4742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN METUGE MASANGO
Title or Position: EXECUTIVE DIRECTOR
Credential: MS, MHR
Phone: 405-942-4740