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General NPI Number Information
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NPI Number | 1972010049
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Entity Type | Organization
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Legal Business Name | ONE HOPE, LLC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 101 AUBURN DR STE B
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City | CLINTON
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State | MS
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Zip | 39056-6001
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Country | US
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Telephone | 601-473-2160
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Fax | 601-473-2336
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Provider Business Mailing Address
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Address Line | 101 AUBURN DR STE B
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City | CLINTON
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State | MS
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Zip | 39056-6001
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Country | US
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Telephone | 601-473-2160
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Fax | 601-473-2336
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | YOLANDA ROSHELLE DIXON
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Credential | EDS
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Telephone | 601-473-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | OH-AGENCY
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License Number State | MS
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