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General NPI Number Information
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NPI Number | 1811125669
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Entity Type | Organization
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Legal Business Name | HOPE HOUSE RESTORATION CENTER
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 4102 CORNERROCK DR
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City | GREENSBORO
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State | NC
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Zip | 27406-8586
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Country | US
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Telephone | 336-697-8451
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Fax | 336-697-7939
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Provider Business Mailing Address
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Address Line | 4102 CORNERROCK DR
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City | GREENSBORO
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State | NC
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Zip | 27406-8586
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Country | US
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Telephone | 336-697-8451
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Fax | 336-697-7939
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Authorized Official
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Title or Position | DIRECTOR
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Name | TRISHA E BECTON
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Credential |
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Telephone | 336-965-8404
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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 | 041916
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License Number State | NC
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