=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700913852
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VILLAGE OF HOPE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1001 LAKE ST
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21801-3141
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-749-6776
-----------------------------------------------------
Fax | 410-742-1126
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2517
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21802-2517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-749-6776
-----------------------------------------------------
Fax | 410-742-1126
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | WILLIAM SCHAULE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-860-4806
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------