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General NPI Number Information
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NPI Number | 1134043144
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Entity Type | Organization
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Legal Business Name | PROVISIONS OF HOPE LLC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 225 N PACE BLVD # 108
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City | PENSACOLA
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State | FL
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Zip | 32505-7915
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Country | US
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Telephone | 404-507-6307
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Fax |
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Provider Business Mailing Address
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Address Line | 2172 W NINE MILE RD STE 167
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City | PENSACOLA
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State | FL
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Zip | 32534-9413
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Country | US
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Telephone | 404-507-6307
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | KANISHA L JOHNSON
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Credential | LCSW
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Telephone | 404-507-6307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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