Provider Demographics
NPI:1285871293
Name:HOPE HEALING BEHAVIORAL HEALTHCARE,P.A.
Entity type:Organization
Organization Name:HOPE HEALING BEHAVIORAL HEALTHCARE,P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SENIORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-530-1038
Mailing Address - Street 1:PO BOX 1243
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-1243
Mailing Address - Country:US
Mailing Address - Phone:870-530-1038
Mailing Address - Fax:
Practice Address - Street 1:4702 W COMMERCIAL DR STE C
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7073
Practice Address - Country:US
Practice Address - Phone:870-530-1038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148591002Medicaid
MS04807375Medicaid
MS04807375Medicaid
AR5C722Medicare PIN