Provider Demographics
NPI:1902541113
Name:WAY OF HOPE INC.
Entity Type:Organization
Organization Name:WAY OF HOPE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:FERNELIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-794-9094
Mailing Address - Street 1:7412 RICKSWAY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5719
Mailing Address - Country:US
Mailing Address - Phone:443-794-9094
Mailing Address - Fax:410-486-3793
Practice Address - Street 1:3312 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-3018
Practice Address - Country:US
Practice Address - Phone:443-623-2449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD679008900Medicaid