Provider Demographics
NPI:1386275204
Name:DAY EAGLE HOPE PROJECT
Entity type:Organization
Organization Name:DAY EAGLE HOPE PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TESCHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW CANDIDATE
Authorized Official - Phone:406-399-1577
Mailing Address - Street 1:PO BOX 1152
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:MT
Mailing Address - Zip Code:59526-1152
Mailing Address - Country:US
Mailing Address - Phone:406-399-1577
Mailing Address - Fax:
Practice Address - Street 1:18243 STATE HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:HARLEM
Practice Address - State:MT
Practice Address - Zip Code:59526-5952
Practice Address - Country:US
Practice Address - Phone:406-399-1577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTBBH-SWLC-LIC-39072Medicaid