Provider Demographics
NPI:1861894198
Name:VISION OF HOPE INTERNATIONAL INC.
Entity type:Organization
Organization Name:VISION OF HOPE INTERNATIONAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FABIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:REVEREND
Authorized Official - Phone:404-272-9214
Mailing Address - Street 1:1074 ARLINGTON AVE SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-3830
Mailing Address - Country:US
Mailing Address - Phone:404-272-9214
Mailing Address - Fax:404-848-1031
Practice Address - Street 1:1074 ARLINGTON AVE SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-3830
Practice Address - Country:US
Practice Address - Phone:404-272-9214
Practice Address - Fax:404-848-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate Vehicle