Provider Demographics
NPI:1194310714
Name:LIVINGHOPE HEALTH SERVICES LLC
Entity type:Organization
Organization Name:LIVINGHOPE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MBA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-695-2807
Mailing Address - Street 1:304 LOGANWOOD CT
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3004
Mailing Address - Country:US
Mailing Address - Phone:443-695-2807
Mailing Address - Fax:
Practice Address - Street 1:304 LOGANWOOD CT
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3004
Practice Address - Country:US
Practice Address - Phone:443-695-2807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty