Provider Demographics
NPI:1154557478
Name:HOPE COMMUNITY SERVICES, INC.
Entity type:Organization
Organization Name:HOPE COMMUNITY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOITIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-848-8863
Mailing Address - Street 1:5701 W TALAVI BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-1880
Mailing Address - Country:US
Mailing Address - Phone:623-848-8863
Mailing Address - Fax:623-848-8864
Practice Address - Street 1:5701 W TALAVI BLVD STE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1880
Practice Address - Country:US
Practice Address - Phone:623-848-8863
Practice Address - Fax:623-848-8864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ431390Medicaid