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General NPI Number Information
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NPI Number | 1043825599
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Entity Type | Organization
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Legal Business Name | HOPE, LOVE, AND DREAM, INC
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 1542 GROVE HILL DR
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City | COLUMBUS
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State | OH
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Zip | 43240-6047
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Country | US
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Telephone | 740-526-1071
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Fax |
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Provider Business Mailing Address
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Address Line | 1491 POLARIS PKWY STE 216
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City | COLUMBUS
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State | OH
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Zip | 43240-2041
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Country | US
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Telephone | 740-526-1071
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | DR. DOMONIQUE RICE
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Credential | PHD, IMFT-S
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Telephone | 740-526-1071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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