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General NPI Number Information
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NPI Number | 1679995914
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Entity Type | Organization
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Legal Business Name | WASHINGTON STREET HOPE CENTER INC
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Dates
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Enumeration Date | 01/06/2014
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Last Update Date | 01/06/2014
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Provider Practice Location Address
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Address Line | 118 S WASHINGTON ST
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City | MARKSVILLE
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State | LA
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Zip | 71351-3022
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Country | US
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Telephone | 318-253-8705
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Fax |
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Provider Business Mailing Address
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Address Line | 118 S WASHINGTON ST
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City | MARKSVILLE
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State | LA
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Zip | 71351-3022
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Country | US
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Telephone | 318-253-8705
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MRS. JO HAMILTON
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Credential | PD
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Telephone | 318-253-8705
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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 | SA0003473
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License Number State | LA
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