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General NPI Number Information
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NPI Number | 1285105650
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Entity Type | Organization
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Legal Business Name | HOME WITH HOPE, INC.
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Dates
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Enumeration Date | 12/11/2018
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Last Update Date | 12/11/2018
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Provider Practice Location Address
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Address Line | 1119 FERRY ST
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City | LAFAYETTE
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State | IN
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Zip | 47901-1532
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Country | US
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Telephone | 765-807-0009
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Fax | 765-807-0030
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Provider Business Mailing Address
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Address Line | 1119 FERRY ST
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City | LAFAYETTE
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State | IN
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Zip | 47901-1532
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Country | US
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Telephone | 765-807-0009
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Fax | 765-807-0030
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | R BRUCE SCHUCKER
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Credential |
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Telephone | 765-807-0009
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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