Provider Demographics
NPI:1144516980
Name:HOPE FAMILY PRACTICE
Entity type:Organization
Organization Name:HOPE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMISSAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-212-1212
Mailing Address - Street 1:24942 E HOOVER PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-7272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15101 E ILIFF AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4543
Practice Address - Country:US
Practice Address - Phone:303-317-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47969261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care