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General NPI Number Information
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NPI Number | 1275949240
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Entity Type | Organization
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Legal Business Name | JOSH'S HOPE FOUNDATION, INC.
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 200 CARDINAL DR STE B
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City | HILLSBOROUGH
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State | NC
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Zip | 27278-2189
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Country | US
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Telephone | 919-245-0072
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Fax | 919-400-4411
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Provider Business Mailing Address
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Address Line | 200 CARDINAL DR STE B
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City | HILLSBOROUGH
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State | NC
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Zip | 27278-2189
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Country | US
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Telephone | 919-245-0072
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Fax | 919-400-4411
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. KERRY A PAKSOY
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Credential | NCC, LPCA
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Telephone | 919-245-0072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | A10056
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License Number State | NC
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