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General NPI Number Information
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NPI Number | 1124492459
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Entity Type | Organization
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Legal Business Name | HOPE HAVEN, LTD
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 500 W 23RD ST
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City | HOPE
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State | AR
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Zip | 71801-8129
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Country | US
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Telephone | 870-777-8655
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Fax | 870-777-5339
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Provider Business Mailing Address
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Address Line | 144 WATERVIEW DR
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City | HOT SPRINGS
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State | AR
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Zip | 71913-2303
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Country | US
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Telephone | 501-545-9009
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Fax | 501-643-9992
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Authorized Official
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Title or Position | PRESIDENT OF THE GENERAL PARTNER
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Name | STEPHEN ANTHONY MARINICK
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Credential |
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Telephone | 501-545-9009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 407
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License Number State | AR
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