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General NPI Number Information
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NPI Number | 1235461252
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Entity Type | Organization
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Legal Business Name | BRIDGE OF HOPE, INC
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 2511 E 46TH ST SUITE E - 1
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City | INDIANAPOLIS
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State | IN
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Zip | 46205-2460
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Country | US
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Telephone | 317-430-3144
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26036
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-0036
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Country | US
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Telephone | 317-430-3144
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. CHARLYE J VANCE
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Credential |
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Telephone | 317-430-3144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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