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General NPI Number Information
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NPI Number | 1699452599
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Entity Type | Organization
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Legal Business Name | HOPE-FULLY LLC
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 6301 BELAIR RD UNIT A
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City | BALTIMORE
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State | MD
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Zip | 21206-1839
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Country | US
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Telephone | 443-835-4353
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Fax |
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Provider Business Mailing Address
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Address Line | 6413 TOTTERIDGE ST
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-3092
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Country | US
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Telephone | 443-449-4191
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JADE JOHNSON
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Credential | LMSW
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Telephone | 443-449-4191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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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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