Provider Demographics
NPI:1518793512
Name:HOPE HEALTH CARE CENTER LLC
Entity type:Organization
Organization Name:HOPE HEALTH CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON-BRACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-278-4018
Mailing Address - Street 1:362 E NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206-5456
Mailing Address - Country:US
Mailing Address - Phone:601-278-4018
Mailing Address - Fax:
Practice Address - Street 1:362 E NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-5456
Practice Address - Country:US
Practice Address - Phone:601-278-4018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care