Provider Demographics
NPI:1972652261
Name:A CHANCE FOR HOPE
Entity type:Organization
Organization Name:A CHANCE FOR HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGLEA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:704-293-4288
Mailing Address - Street 1:820 S LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3641
Mailing Address - Country:US
Mailing Address - Phone:704-732-3746
Mailing Address - Fax:704-732-3746
Practice Address - Street 1:820 S LAUREL ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3641
Practice Address - Country:US
Practice Address - Phone:704-732-3746
Practice Address - Fax:704-732-3746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL055087322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children