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General NPI Number Information
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NPI Number | 1851064034
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Entity Type | Organization
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Legal Business Name | HOPE MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 870 ALDER STREET
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City | ELGIN
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State | OR
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Zip | 97827
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Country | US
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Telephone | 541-624-3117
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Fax | 541-605-5361
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Provider Business Mailing Address
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Address Line | PO BOX 614
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City | ELGIN
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State | OR
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Zip | 97827-0614
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Country | US
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Telephone | 541-624-3117
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Fax | 541-605-5361
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Authorized Official
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Title or Position | PSYCH NP/OWNER
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Name | CONNIE MARIE CARTER
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Credential | PMHNP
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Telephone | 541-624-3117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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