Healthcare Provider Details

I. General information

NPI: 1942337183
Provider Name (Legal Business Name): HOPE FAMILY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 NEW HIGHWAY 52 E
WESTMORELAND TN
37186-5060
US

IV. Provider business mailing address

12124 HIGHWAY 52 W
WESTMORELAND TN
37186-5063
US

V. Phone/Fax

Practice location:
  • Phone: 615-644-2000
  • Fax: 615-644-2078
Mailing address:
  • Phone: 615-644-2000
  • Fax: 615-644-2078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER G DITTES
Title or Position: EXECUTIVE DIRECTOR
Credential: PA-C
Phone: 615-644-2000