Provider Demographics
NPI:1487923520
Name:HANDS OF HOPE HEALTH CARE CENTER
Entity type:Organization
Organization Name:HANDS OF HOPE HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:251-287-6146
Mailing Address - Street 1:4625 MOFFETT RD.
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36618
Mailing Address - Country:US
Mailing Address - Phone:251-287-6146
Mailing Address - Fax:251-287-6154
Practice Address - Street 1:4625 MOFFETT RD.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36618
Practice Address - Country:US
Practice Address - Phone:251-287-6146
Practice Address - Fax:251-287-6154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL135152Medicaid
AL1306875828OtherINDIVIDUAL NPI
AL135146Medicaid
AL51123471OtherBLUE CROSS BLUE SHIELD OF ALABAMA
AL1059384OtherALABAMA LICENSE
AL102I502341Medicare UPIN
AL102G702340Medicare UPIN