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NPI Code Detail

MEDICARE: HOPE ADVANCEMENT, INC

MEDICARE: HOPE ADVANCEMENT, 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1841659885
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOPE ADVANCEMENT, INC
Provider Business Mailing Address
First Line : 2810 ASHLEY PHOSPHATE RD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29418-6405
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2810 ASHLEY PHOSPHATE RD
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29418-6405
Country : US
Telephone Number : 704-956-3062
Fax Number :
Authorized Official
Title or Position : CEO
Name : DEMETRIUS CRAYTON
Credential :
Telephone Number : 704-956-3062
Provider Enumeration Date : 02/18/2016
Last Update Date : 02/18/2016

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