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General NPI Number Information
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NPI Number | 1316561475
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Entity Type | Organization
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Legal Business Name | CENTER FOR HEALING AND HOPE
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 400 W LINCOLN AVE
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City | GOSHEN
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State | IN
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Zip | 46526-2413
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Country | US
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Telephone | 574-534-4744
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Fax | 574-537-1186
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Provider Business Mailing Address
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Address Line | PO BOX 195
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City | GOSHEN
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State | IN
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Zip | 46527-0195
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Country | US
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Telephone | 574-534-4744
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Fax | 574-537-1186
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISSY SCHROCK
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Credential |
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Telephone | 574-534-4744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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