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General NPI Number Information
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NPI Number | 1396328514
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Entity Type | Organization
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Legal Business Name | BIG MOMMAS HOUSE OF HOPE
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 1315 DUTCH HOLLOW RD
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City | BEAVER
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State | OH
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Zip | 45613-9745
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Country | US
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Telephone | 740-357-2766
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Fax |
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Provider Business Mailing Address
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Address Line | 110 SMITH PERRY RD
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City | LUCASVILLE
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State | OH
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Zip | 45648-8666
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Country | US
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Telephone | 740-357-2766
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA PRICE
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Credential |
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Telephone | 740-977-8192
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 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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