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General NPI Number Information
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NPI Number | 1518218858
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Entity Type | Organization
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Legal Business Name | HOUSE OF HOPE HOUSE OF FAITH
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 11625 CORNELL ST
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City | ADELANTO
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State | CA
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Zip | 92301-3689
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Country | US
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Telephone | 760-701-0175
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Fax | 760-246-8321
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Provider Business Mailing Address
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Address Line | 13287 CLAREMONT AVE
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City | VICTORVILLE
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State | CA
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Zip | 92392-7251
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Country | US
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Telephone | 760-701-0175
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Fax | 760-246-8321
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Authorized Official
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Title or Position | FOUNDER, SENIOR ADMINISTRATOR
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Name | MR. RICHARD P FIDDLER
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Credential | CFO
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Telephone | 760-403-3531
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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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