Provider Demographics
NPI:1194552992
Name:BETSY ANN ROSS HOUSE OF HOPE
Entity type:Organization
Organization Name:BETSY ANN ROSS HOUSE OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNELL DU HOUX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-530-0466
Mailing Address - Street 1:PO BOX 5661
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04332-5661
Mailing Address - Country:US
Mailing Address - Phone:207-530-0466
Mailing Address - Fax:
Practice Address - Street 1:8 SUMMER ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5129
Practice Address - Country:US
Practice Address - Phone:207-530-0466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodging
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable