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General NPI Number Information
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NPI Number | 1669090635
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Entity Type | Organization
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Legal Business Name | GENERATION HOPE
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 415 MICHIGAN AVE NE # 410
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City | WASHINGTON
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State | DC
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Zip | 20017-4500
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Country | US
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Telephone | 202-734-5838
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Fax |
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Provider Business Mailing Address
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Address Line | 415 MICHIGAN AVE NE # 410
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City | WASHINGTON
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State | DC
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Zip | 20017-4500
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Country | US
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Telephone | 202-734-5838
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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 | MR. REGINALD MAURICE GRANT
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Credential |
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Telephone | 301-254-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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