MEDICARE: HOPE HOUSE MINISTRIES INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	347C00000X	Private Vehicle
3	174200000X	Meals Provider
4	177F00000X	Lodging Provider
5	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1326664426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE HOUSE MINISTRIES INC.

Provider Business Mailing Address
First Line	:	PO BOX 323
Second Line	:
City	:	RAVENSWOOD
State	:	WV
Zip	:	26164-0323
Country	:	US
Telephone Number	:	304-532-3712
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 WASHINGTON ST
Second Line	:
City	:	RAVENSWOOD
State	:	WV
Zip	:	26164-1143
Country	:	US
Telephone Number	:	304-532-3712
Fax Number	:

Authorized Official
Title or Position	:	PEER SUPPORT SPECIALIST
Name	:	MISTY DAWN ADKINS
Credential	:
Telephone Number	:	304-532-3712

Provider Enumeration Date	:	06/24/2020
Last Update Date	:	06/24/2020

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