Provider Demographics
NPI:1700696606
Name:HOPE RESIDENTIAL HEALTHCARE LLC
Entity type:Organization
Organization Name:HOPE RESIDENTIAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGABE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:515-418-5807
Mailing Address - Street 1:10239 SOUTHERWICK PL
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2558
Mailing Address - Country:US
Mailing Address - Phone:515-418-5807
Mailing Address - Fax:
Practice Address - Street 1:10239 SOUTHERWICK PL
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2558
Practice Address - Country:US
Practice Address - Phone:515-418-5807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities