Provider Demographics
NPI:1285103028
Name:GOOD HOPE WELLNESS INCORPORATED
Entity type:Organization
Organization Name:GOOD HOPE WELLNESS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:AMELIA
Authorized Official - Last Name:CETOLA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:508-281-1064
Mailing Address - Street 1:1188 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-5140
Mailing Address - Country:US
Mailing Address - Phone:508-281-1064
Mailing Address - Fax:508-281-4013
Practice Address - Street 1:1188 COUNTY ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:MA
Practice Address - Zip Code:02726-5140
Practice Address - Country:US
Practice Address - Phone:508-281-1064
Practice Address - Fax:508-281-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-22
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty