Basic Information
Provider Information | |||||||||
NPI: | 1447718796 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | HOPE INDUSTRIES LLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1711 E DESERT INN RD | ||||||||
Address2: |   | ||||||||
City: | LAS VEGAS | ||||||||
State: | NV | ||||||||
PostalCode: | 89169 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7028391088 | ||||||||
FaxNumber: | 7026502800 | ||||||||
Practice Location | |||||||||
Address1: | 1711 E DESERT INN RD | ||||||||
Address2: |   | ||||||||
City: | LAS VEGAS | ||||||||
State: | NV | ||||||||
PostalCode: | 89169 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7028391088 | ||||||||
FaxNumber: | 7026502800 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/06/2019 | ||||||||
LastUpdateDate: | 03/06/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | COFER | ||||||||
AuthorizedOfficialFirstName: | KELLY | ||||||||
AuthorizedOfficialMiddleName: | ELIZABETH | ||||||||
AuthorizedOfficialTitleorPosition: | CEO/OWNER | ||||||||
AuthorizedOfficialTelephone: | 7028391088 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MRS. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 372500000X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Related Providers | Chore Provider |   | 372600000X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Related Providers | Adult Companion |   | 376J00000X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Related Providers | Homemaker |   | 235Z00000X |   |   | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |   |
No ID Information.