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General NPI Number Information
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NPI Number | 1750421434
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Entity Type | Organization
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Legal Business Name | HOPE STREET, LLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2007 LYNN RD
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City | GREENSBORO
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State | NC
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Zip | 27405-6519
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Country | US
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Telephone | 336-375-5985
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Fax | 336-375-0253
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Provider Business Mailing Address
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Address Line | 2007 LYNN RD
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City | GREENSBORO
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State | NC
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Zip | 27405-6519
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Country | US
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Telephone | 336-375-5985
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Fax | 336-375-0253
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. DENNIS WHITE
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Credential |
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Telephone | 336-375-5985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-041-719
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License Number State | NC
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