Provider Demographics
NPI:1134955982
Name:REWIRE IN HOPE
Entity type:Organization
Organization Name:REWIRE IN HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-288-5034
Mailing Address - Street 1:1809 4TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-5713
Mailing Address - Country:US
Mailing Address - Phone:202-288-5034
Mailing Address - Fax:
Practice Address - Street 1:1809 4TH AVE SW
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-5713
Practice Address - Country:US
Practice Address - Phone:202-288-5034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REWIREINHOPE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness