Provider Demographics
NPI:1962873117
Name:WILMINGTON HEALING WITH HOPE
Entity type:Organization
Organization Name:WILMINGTON HEALING WITH HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GRIEF SUPPORT AND HEALTH ADVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOUGHNOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-509-0444
Mailing Address - Street 1:1904 EASTWOOD RD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5721
Mailing Address - Country:US
Mailing Address - Phone:910-509-0444
Mailing Address - Fax:910-509-0449
Practice Address - Street 1:1904 EASTWOOD RD
Practice Address - Street 2:SUITE 309
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5721
Practice Address - Country:US
Practice Address - Phone:910-509-0444
Practice Address - Fax:910-509-0449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC121807251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care