MEDICARE: HOPE HOUSING OF MIAMI, 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	315P00000X	Intellectual Disabilities Intermediate Care Facility		OK

General Provider Information

NPI Number	:	1326189192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE HOUSING OF MIAMI, INC

Provider Business Mailing Address
First Line	:	PO BOX 903
Second Line	:
City	:	VINITA
State	:	OK
Zip	:	74301-0903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 3RD AVE NW
Second Line	:
City	:	MIAMI
State	:	OK
Zip	:	74354-5704
Country	:	US
Telephone Number	:	918-540-0707
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID SVEDMAN
Credential	:
Telephone Number	:	918-256-7825

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/22/2020

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