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General NPI Number Information
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NPI Number | 1255925707
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Entity Type | Organization
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Legal Business Name | HOPE CLINIC AND CARE CENTER INC.
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 1814 APPLETON RD
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City | MENASHA
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State | WI
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Zip | 54952-1110
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Country | US
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Telephone | 920-931-1150
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Fax | 920-931-1159
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Provider Business Mailing Address
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Address Line | 1814 APPLETON RD
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City | MENASHA
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State | WI
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Zip | 54952-1110
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Country | US
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Telephone | 920-931-1150
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Fax | 920-931-1159
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHELBY MILLER
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Credential |
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Telephone | 920-931-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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