Healthcare Provider Details

I. General information

NPI: 1902413511
Provider Name (Legal Business Name): FAMILY HOPE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 09/28/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 BRIDLEPATH CT
FREDERICKSBURG VA
22408-8813
US

IV. Provider business mailing address

4201 BRIDLEPATH CT
FREDERICKSBURG VA
22408-8813
US

V. Phone/Fax

Practice location:
  • Phone: 540-847-1936
  • Fax:
Mailing address:
  • Phone: 540-847-1936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: NICOLE THERESA THOMAS
Title or Position: CEO AND CLINICAL DIRECTOR
Credential: BCBA
Phone: 540-847-1936