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NPI 1629875901

NPI 1629875901 : HOPES PROMISE RESPITE LLC : ATCO, NJ

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General NPI Number Information
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    NPI Number           |    1629875901
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    Entity Type          |    Organization 
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    Legal Business Name  |    HOPES PROMISE RESPITE LLC 
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Dates
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    Enumeration Date     |    02/25/2025
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    Last Update Date     |    04/15/2025
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Provider Practice Location Address
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    Address Line         |    331 WHITE HORSE PIKE FL 2 
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    City                 |    ATCO
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    State                |    NJ
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    Zip                  |    08004-2230
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    Country              |    US
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    Telephone            |    609-200-1320
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    Fax                  |    856-250-1275
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Provider Business Mailing Address
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    Address Line         |    331 WHITE HORSE PIKE FL 2 
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    City                 |    ATCO
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    State                |    NJ
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    Zip                  |    08004-2230
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    Country              |    US
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    Telephone            |    609-200-1320
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    Fax                  |    856-250-1275
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Authorized Official
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    Title or Position    |    EXECUTIVE DIRECTOR
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    Name                 |     HOPE JEKA KYE 
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    Credential           |    
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    Telephone            |    609-200-1320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TC2200X
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    Taxonomy Name        |    Clinical Child & Adolescent Psychologist
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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        |    385HR2060X
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    Taxonomy Name        |    Child Intellectual and/or Developmental Disabilities Respite Care
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    License Number       |    
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    License Number State |    
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