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General NPI Number Information
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NPI Number | 1356695860
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Entity Type | Organization
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Legal Business Name | FAITH AND HOPE WELLNESS CENTER
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 11/06/2012
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Provider Practice Location Address
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Address Line | 200 WASHINGTON ST SUITE-A
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City | MONROE
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State | LA
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Zip | 71201-6757
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Country | US
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Telephone | 318-388-6808
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Fax | 318-388-6893
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Provider Business Mailing Address
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Address Line | 200 WASHINGTON ST SUITE-A
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City | MONROE
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State | LA
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Zip | 71201-6757
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Country | US
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Telephone | 318-388-6808
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Fax | 318-388-6893
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Authorized Official
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Title or Position | OWNER
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Name | MR. NEAL W ANGRUM
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Credential |
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Telephone | 318-450-1478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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