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General NPI Number Information
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NPI Number | 1669811451
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Entity Type | Organization
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Legal Business Name | HOPE VILLAGE FOR CHILDREN, INC.
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 2433 23RD AVE
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City | MERIDIAN
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State | MS
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Zip | 39301-2156
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Country | US
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Telephone | 601-553-8660
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Fax | 601-553-8669
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Provider Business Mailing Address
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Address Line | PO BOX 26
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City | MERIDIAN
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State | MS
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Zip | 39302-0026
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Country | US
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Telephone | 601-553-8660
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Fax | 601-553-8669
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TINA AYCOCK
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Credential |
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Telephone | 601-553-8660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | HVCBCSCOMLIV01
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License Number State | MS
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