Provider Demographics
NPI:1477381960
Name:GARDENS OF HOPE
Entity type:Organization
Organization Name:GARDENS OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:AKWIASDI
Authorized Official - Middle Name:
Authorized Official - Last Name:REVELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-682-7197
Mailing Address - Street 1:249 BRAYDEN DR
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-8013
Mailing Address - Country:US
Mailing Address - Phone:704-682-7197
Mailing Address - Fax:
Practice Address - Street 1:4124 PECAN DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-2423
Practice Address - Country:US
Practice Address - Phone:704-682-7197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility