Healthcare Provider Details

I. General information

NPI: 1427661941
Provider Name (Legal Business Name): A HOPE AND A FUTURE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2932 ALTRURIA RD
BARTLETT TN
38134-3862
US

IV. Provider business mailing address

2932 ALTRURIA RD
BARTLETT TN
38134-3862
US

V. Phone/Fax

Practice location:
  • Phone: 901-277-5797
  • Fax: 866-891-7647
Mailing address:
  • Phone: 901-277-5797
  • Fax: 866-891-7647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL BERKES
Title or Position: PRESIDENT
Credential: LPC/MHSP
Phone: 901-277-5797