Provider Demographics
NPI:1790656627
Name:HOPE AND DIVINE PURPOSE TRANSITIONAL LIVING HOME, INC
Entity type:Organization
Organization Name:HOPE AND DIVINE PURPOSE TRANSITIONAL LIVING HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ISRAEIO
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, QMHP
Authorized Official - Phone:708-537-3369
Mailing Address - Street 1:103 GIRARD BLVD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-3105
Mailing Address - Country:US
Mailing Address - Phone:708-537-3369
Mailing Address - Fax:
Practice Address - Street 1:725 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6103
Practice Address - Country:US
Practice Address - Phone:708-537-3369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable