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General NPI Number Information
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NPI Number | 1033461298
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Entity Type | Organization
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Legal Business Name | COMMUNITY HOPE AGENCY, INC.
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 3915 MALLARD DR
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City | NASHVILLE
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State | TN
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Zip | 37218-2007
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Country | US
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Telephone | 615-251-0954
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Fax | 615-251-1103
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Provider Business Mailing Address
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Address Line | 3915 MALLARD DR
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City | NASHVILLE
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State | TN
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Zip | 37218-2007
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Country | US
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Telephone | 615-251-0954
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Fax | 615-251-1103
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SANDRA EILEEN FLAVIN
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Credential |
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Telephone | 615-251-0954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 1000000007180
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License Number State | TN
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