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General NPI Number Information
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NPI Number | 1487138913
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Entity Type | Organization
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Legal Business Name | FOR HOPE'S SAKE, LLC
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 9905 SOUTHHALL ROAD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133
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Country | US
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Telephone | 443-516-7741
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Fax |
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Provider Business Mailing Address
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Address Line | 717 PERTHSHIRE PL
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City | ABINGDON
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State | MD
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Zip | 21009-2673
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Country | US
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Telephone | 443-889-5265
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BEHAVIORAL HEALTH
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Name | TIFFINI DAVIS
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Credential | LBSW
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Telephone | 443-889-5265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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