Basic Information
| Provider Information | |||||||||
| NPI: | 1831845593 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOPEFIELD MENTAL HEALTH FOUNDATION, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 SANDSTONE CIR | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383052073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7312401695 | ||||||||
| FaxNumber: | 7312401694 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 SANDSTONE CIR | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383052073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7312401695 | ||||||||
| FaxNumber: | 7312401694 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2022 | ||||||||
| LastUpdateDate: | 02/22/2022 | ||||||||
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| AuthorizedOfficialLastName: | NWEDO | ||||||||
| AuthorizedOfficialFirstName: | SYLVESTER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7312401695 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.