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NPI Code Detail

MEDICARE: HOPE HAVEN, INC.

MEDICARE: HOPE HAVEN, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13245S0500XChildren's Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1184589525
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOPE HAVEN, INC.
Provider Business Mailing Address
First Line : 3815 N TRYON ST
Second Line :
City : CHARLOTTE
State : NC
Zip : 28206-2060
Country : US
Telephone Number : 704-372-8809
Fax Number :
Provider Business Practice Location Address
First Line : 3815 N TRYON ST
Second Line :
City : CHARLOTTE
State : NC
Zip : 28206-2060
Country : US
Telephone Number : 704-372-8809
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF WFDH
Name : EBONY COPELAND
Credential :
Telephone Number : 704-963-7762
Provider Enumeration Date : 12/18/2025
Last Update Date : 12/18/2025

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