Provider Demographics
NPI:1063898476
Name:HOPE 4 TOMORROW LLC
Entity type:Organization
Organization Name:HOPE 4 TOMORROW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROXXI
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:309-310-9621
Mailing Address - Street 1:2422 E WASHINGTON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4478
Mailing Address - Country:US
Mailing Address - Phone:309-310-9621
Mailing Address - Fax:309-454-6501
Practice Address - Street 1:2422 E WASHINGTON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4478
Practice Address - Country:US
Practice Address - Phone:309-310-9621
Practice Address - Fax:309-454-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0155431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty