Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Health Maintenance Organization |
302R00000X |
| NPI Number | 1255871026 |
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| LBN Legal business name | HOPE JESC INC | ||||||||||||||||
| Authorized official | RYAN DOUPE - (SECRETARY) | ||||||||||||||||
| Entity | Organization | ||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||
| Enumeration date | 02/27/2017 | ||||||||||||||||
| Last updated | 03/17/2017 - About 9 years ago | ||||||||||||||||
| Identifiers |
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