Healthcare Provider Details

I. General information

NPI: 1346109303
Provider Name (Legal Business Name): HOPEFUL HEARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BUFORD RD STE 120
NORTH CHESTERFIELD VA
23235-5292
US

IV. Provider business mailing address

10628 W WOOD ST
TOLLESON AZ
85353-5427
US

V. Phone/Fax

Practice location:
  • Phone: 804-912-9662
  • Fax:
Mailing address:
  • Phone: 480-410-8944
  • Fax:

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 Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JACHEL GRAY
Title or Position: OWNER
Credential:
Phone: 804-912-9662