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NPI Code Detail

MEDICARE: VIRTUAL HOPE BEHAVIORAL HEALTH SERVICES LLC

MEDICARE: VIRTUAL HOPE BEHAVIORAL HEALTH SERVICES 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
1363LF0000XFamily Nurse Practitioner
2363LP2300XPrimary Care Nurse Practitioner
3101YM0800XMental Health Counselor
4363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1750144333
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIRTUAL HOPE BEHAVIORAL HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 5945 LANSDOWNE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151
Country : US
Telephone Number : 267-577-0719
Fax Number :
Provider Business Practice Location Address
First Line : 5945 LANSDOWNE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151-3932
Country : US
Telephone Number : 267-485-5227
Fax Number : 267-485-5228
Authorized Official
Title or Position : OWNER
Name : BERNADETTE MOMOH
Credential : NURSE PRACTITIONER
Telephone Number : 267-485-5227
Provider Enumeration Date : 02/05/2024
Last Update Date : 06/12/2025

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