Provider Demographics
NPI:1558487371
Name:ONE HOPE UNITED, FL REGION INC.
Entity type:Organization
Organization Name:ONE HOPE UNITED, FL REGION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FL REGION BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:407-379-2900
Mailing Address - Street 1:5749 WESTGATE DR.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-9991
Mailing Address - Country:US
Mailing Address - Phone:407-379-2900
Mailing Address - Fax:407-378-5344
Practice Address - Street 1:5749 WESTGATE DR.
Practice Address - Street 2:SUITE 202
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-9991
Practice Address - Country:US
Practice Address - Phone:407-379-2900
Practice Address - Fax:407-378-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW82131041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL768595500Medicaid