Provider Demographics
NPI:1396105599
Name:HOPE YOUTH AND FAMILY SERVICES INC
Entity type:Organization
Organization Name:HOPE YOUTH AND FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEMETRIUS
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:404-509-9508
Mailing Address - Street 1:170 BASTILLE WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7652
Mailing Address - Country:US
Mailing Address - Phone:404-509-9508
Mailing Address - Fax:
Practice Address - Street 1:170 BASTILLE WAY
Practice Address - Street 2:SUITE A
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7652
Practice Address - Country:US
Practice Address - Phone:404-509-9508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251S00000XAgenciesCommunity/Behavioral Health
No347C00000XTransportation ServicesPrivate Vehicle