MEDICARE: PASTURES OF HOPE LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1740093970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASTURES OF HOPE LLC

Provider Business Mailing Address
First Line	:	9171 BEESON ST NE
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-8518
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5495 MEESE RD NE
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-6302
Country	:	US
Telephone Number	:	330-415-4794
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	BENJAMIN CHANDLER
Credential	:	LPC
Telephone Number	:	330-415-4794

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	01/30/2025

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Directions to “PASTURES OF HOPE LLC ” Practice Location

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