MEDICARE: REDIRECTING HOPE 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
1	172V00000X	Community Health Worker
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1215755095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDIRECTING HOPE INC

Provider Business Mailing Address
First Line	:	12708 SAN JOSE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-2689
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12708 SAN JOSE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-2689
Country	:	US
Telephone Number	:	804-337-9048
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	ANTHONY HINES
Credential	:
Telephone Number	:	804-337-9048

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	06/03/2025

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Directions to “REDIRECTING HOPE INC ” Practice Location

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