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General NPI Number Information
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NPI Number | 1609448844
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Entity Type | Organization
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Legal Business Name | HOPE RESTORATION MINISTRIES
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 6114 S FONTANA AVENUE
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City | TUCSON
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State | AZ
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Zip | 85706-4044
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Country | US
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Telephone | 520-261-0818
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Fax |
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Provider Business Mailing Address
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Address Line | 4214 W FIRETHORN ST
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City | TUCSON
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State | AZ
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Zip | 85741-4044
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Country | US
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Telephone | 520-304-3389
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. STEPHANIE LYNN BERT
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Credential | LAC
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Telephone | 520-304-3389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 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 #4
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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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