Provider Demographics
NPI:1215343413
Name:HOME OF HOPE, INC.
Entity type:Organization
Organization Name:HOME OF HOPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-558-9865
Mailing Address - Street 1:228 MEADOW ST
Mailing Address - Street 2:SUITE 001
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1807
Mailing Address - Country:US
Mailing Address - Phone:203-437-8896
Mailing Address - Fax:203-437-8456
Practice Address - Street 1:228 MEADOW ST
Practice Address - Street 2:SUITE 001
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1807
Practice Address - Country:US
Practice Address - Phone:203-437-8896
Practice Address - Fax:203-437-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0082011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty