Healthcare Provider Details

I. General information

NPI: 1326664426
Provider Name (Legal Business Name): HOPE HOUSE MINISTRIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WASHINGTON ST
RAVENSWOOD WV
26164-1143
US

IV. Provider business mailing address

PO BOX 323
RAVENSWOOD WV
26164-0323
US

V. Phone/Fax

Practice location:
  • Phone: 304-532-3712
  • Fax:
Mailing address:
  • Phone: 304-532-3712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MISTY DAWN ADKINS
Title or Position: PEER SUPPORT SPECIALIST
Credential:
Phone: 304-532-3712