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General NPI Number Information
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NPI Number | 1184979908
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Entity Type | Organization
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Legal Business Name | HOPE AND A FUTURE MINISTRIES, INC.
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 680 MAYPORT RD.
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City | ATLANTIC BEACH
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State | FL
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Zip | 32233
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Country | US
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Telephone | 904-339-5937
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Fax |
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Provider Business Mailing Address
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Address Line | 14149 WASHBURN CT.
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City | JACKSONVILLE
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State | FL
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Zip | 32250
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Country | US
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Telephone | 904-339-5937
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MS. CARISSA LYNETTE DORE
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Credential |
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Telephone | 904-339-5937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | N10000009242
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | N10000009242
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License Number State | FL
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