Provider Demographics
NPI:1285735225
Name:HOPE YOUTH SERVICES, INC
Entity type:Organization
Organization Name:HOPE YOUTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:R
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-625-6909
Mailing Address - Street 1:200 W 1ST ST
Mailing Address - Street 2:SUITE 625
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-4668
Mailing Address - Country:US
Mailing Address - Phone:505-625-6909
Mailing Address - Fax:505-625-9442
Practice Address - Street 1:200 W 1ST ST
Practice Address - Street 2:SUITE 625
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4668
Practice Address - Country:US
Practice Address - Phone:505-625-6909
Practice Address - Fax:505-625-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM58388354Medicaid