MEDICARE: HOPE IS HERE

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	3245S0500X	Children's Substance Abuse Rehabilitation Facility
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1598335242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE IS HERE

Provider Business Mailing Address
First Line	:	15571 LUCKY PL
Second Line	:
City	:	SYLMAR
State	:	CA
Zip	:	91342-3570
Country	:	US
Telephone Number	:	323-385-4442
Fax Number	:

Provider Business Practice Location Address
First Line	:	16730 SCHOENBORN ST
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-6108
Country	:	US
Telephone Number	:	323-385-4442
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BOLAJI ADEDURO
Credential	:
Telephone Number	:	323-385-4442

Provider Enumeration Date	:	06/25/2021
Last Update Date	:	09/15/2021

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Directions to “HOPE IS HERE ” Practice Location

Language	Start Address	Practice Location

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