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General NPI Number Information
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NPI Number | 1467987701
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Entity Type | Organization
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Legal Business Name | ONE HOPE, LLC
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | 2 DOVE WAY CIR
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City | CLINTON
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State | MS
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Zip | 39056-3589
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Country | US
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Telephone | 601-201-6862
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Fax |
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Provider Business Mailing Address
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Address Line | 1896 HWY. 471
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City | BRANDON
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State | MS
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Zip | 39047
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Country | US
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Telephone | 769-241-5146
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ADOOREE MICHELLE TULLAR
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Credential |
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Telephone | 769-241-5146
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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 | MS
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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