Provider Demographics
NPI:1154545663
Name:HOPE HAVEN INC
Entity type:Organization
Organization Name:HOPE HAVEN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-372-8809
Mailing Address - Street 1:3815 N TRYON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2060
Mailing Address - Country:US
Mailing Address - Phone:704-372-8809
Mailing Address - Fax:
Practice Address - Street 1:3815 N TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2060
Practice Address - Country:US
Practice Address - Phone:704-372-8809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health