=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356085567
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOPE'S HUMBLE HANDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2022
-----------------------------------------------------
Last Update Date | 04/24/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31 POND ST
-----------------------------------------------------
City | STRATFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06614-5224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-296-1729
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 19
-----------------------------------------------------
City | STRATFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06615-0019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-296-1729
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPECIAL EDUCATOR
-----------------------------------------------------
Name | HOPE BAXTER
-----------------------------------------------------
Credential | MS ED
-----------------------------------------------------
Telephone | 646-296-1729
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------