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General NPI Number Information
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NPI Number | 1184471120
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Entity Type | Organization
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Legal Business Name | HOPE HOUSE RESIDENTIAL CARE HOME
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Dates
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Enumeration Date | 05/06/2024
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 5549 BERLIN DR
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City | PORT RICHEY
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State | FL
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Zip | 34668-6309
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Country | US
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Telephone | 727-339-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 5549 BERLIN DR
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City | PORT RICHEY
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State | FL
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Zip | 34668-6309
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Country | US
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Telephone | 727-339-3166
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Fax |
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Authorized Official
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Title or Position | OWNER / CAREGIVER
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Name | TONIA RODGERS
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Credential | CNA 409553
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Telephone | 727-598-5357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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