Basic Information
| Provider Information | |||||||||
| NPI: | 1770142556 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOPE GROWS BEHAVIORAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 S BROADWAY STE 310 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945965218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8885318385 | ||||||||
| FaxNumber: | 9252641902 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 S BROADWAY STE 310 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945965218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8885318385 | ||||||||
| FaxNumber: | 9252641902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2019 | ||||||||
| LastUpdateDate: | 06/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | WHITWORTH | ||||||||
| AuthorizedOfficialFirstName: | CHELSEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 9254055011 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst | 252Y00000X | N | Agencies | Early Intervention Provider Agency | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.