Healthcare Provider Details

I. General information

NPI: 1104487412
Provider Name (Legal Business Name): CENTER OF HOPE COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 NE ROBERTS AVE STE 100
GRESHAM OR
97030-7483
US

IV. Provider business mailing address

510 NE ROBERTS AVE STE 100
GRESHAM OR
97030-7483
US

V. Phone/Fax

Practice location:
  • Phone: 971-284-9529
  • Fax:
Mailing address:
  • Phone: 971-284-9529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SCOTT NEWMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 360-448-7260