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General NPI Number Information
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NPI Number | 1003308966
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Entity Type | Organization
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Legal Business Name | H.O.P.E. INTERGRATIVE COMMUNITY SUPPORT SERVICES
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 322 GREENACRES BLVD
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City | BOSSIER CITY
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State | LA
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Zip | 71111-6052
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Country | US
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Telephone | 318-458-8004
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Fax |
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Provider Business Mailing Address
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Address Line | 164 DOGWOOD SOUTH LN
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City | HAUGHTON
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State | LA
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Zip | 71037-7512
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Country | US
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Telephone | 318-615-4005
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. MYESHA T DAVIS
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Credential | LMSW
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Telephone | 318-458-8004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | LA
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