=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194540369
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART OF HOPE BEHAVIORAL AND COUNSELING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2024
-----------------------------------------------------
Last Update Date | 11/21/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 750 WELLINGTON CT
-----------------------------------------------------
City | VINELAND
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08360-5866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-484-1293
-----------------------------------------------------
Fax | 856-234-0091
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 750 WELLINGTON CT
-----------------------------------------------------
City | VINELAND
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08360-5866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-484-1293
-----------------------------------------------------
Fax | 856-234-0091
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NGOZI RITA OKAFOR
-----------------------------------------------------
Credential | APN
-----------------------------------------------------
Telephone | 856-405-7070
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------