Basic Information
| Provider Information | |||||||||
| NPI: | 1497954226 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HOPE COUNSELING CENTER | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | DELTA | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 241769 | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995241769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077702301 | ||||||||
| FaxNumber: | 9077702325 | ||||||||
| Practice Location | |||||||||
| Address1: | 2395 KIMBALL STREET | ||||||||
| Address2: | |||||||||
| City: | DELTA JUNCTION | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074518208 | ||||||||
| FaxNumber: | 9074518207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2007 | ||||||||
| LastUpdateDate: | 07/12/2007 | ||||||||
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| AuthorizedOfficialLastName: | TURNBOW | ||||||||
| AuthorizedOfficialFirstName: | KERRY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9074518208 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | L.P.C. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.