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General NPI Number Information
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NPI Number | 1891173944
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Entity Type | Organization
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Legal Business Name | H.O.P.E THERAPEUTIC SERVICES, INC.
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Dates
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Enumeration Date | 05/09/2015
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Last Update Date | 05/09/2015
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Provider Practice Location Address
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Address Line | 4811 CHIPPENDALE DR SUITE 601
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City | SACRAMENTO
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State | CA
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Zip | 95841-2555
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Country | US
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Telephone | 916-514-8030
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Fax | 916-514-8029
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Provider Business Mailing Address
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Address Line | 4811 CHIPPENDALE DR SUITE 601
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City | SACRAMENTO
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State | CA
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Zip | 95841-2555
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Country | US
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Telephone | 916-514-8030
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Fax | 916-514-8029
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | BETHANY A MARONEY-PETERSON
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Credential | MA, LMFT
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Telephone | 916-514-8030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | C3524117
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License Number State | CA
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