Healthcare Provider Details

I. General information

NPI: 1558479683
Provider Name (Legal Business Name): ST. HOPE FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 WEST LOOP S SUITE 560
BELLAIRE TX
77401-4516
US

IV. Provider business mailing address

6200 SAVOY DR SUITE 540
HOUSTON TX
77036-3338
US

V. Phone/Fax

Practice location:
  • Phone: 713-839-7111
  • Fax: 713-839-7156
Mailing address:
  • Phone: 713-778-1300
  • Fax: 713-778-0827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. RODNEY N GOODIE
Title or Position: CEO
Credential:
Phone: 713-778-1300