Healthcare Provider Details

I. General information

NPI: 1497612295
Provider Name (Legal Business Name): HOPE HORIZON WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N MAIN ST STE C
SUFFOLK VA
23434-4466
US

IV. Provider business mailing address

PO BOX 1211
SUFFOLK VA
23439-1211
US

V. Phone/Fax

Practice location:
  • Phone: 757-477-0102
  • Fax: 757-942-2590
Mailing address:
  • Phone:
  • Fax: 757-942-2590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: LEVITICUS LOFTON
Title or Position: CEO
Credential: LCSW
Phone: 757-582-9567