Provider Demographics
NPI:1558781294
Name:HOPE EXTENDED CARE SERVICES INC
Entity type:Organization
Organization Name:HOPE EXTENDED CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:724-901-0003
Mailing Address - Street 1:202 W NESHANNOCK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1115
Mailing Address - Country:US
Mailing Address - Phone:724-901-0003
Mailing Address - Fax:724-946-2156
Practice Address - Street 1:202 W NESHANNOCK AVE
Practice Address - Street 2:
Practice Address - City:NEW WILMINGTON
Practice Address - State:PA
Practice Address - Zip Code:16142-1115
Practice Address - Country:US
Practice Address - Phone:724-901-0003
Practice Address - Fax:724-946-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426144207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty