Basic Information
| Provider Information | |||||||||
| NPI: | 1750498739 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HOUSE OF HOPE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 857 E 200 S | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841022334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014873276 | ||||||||
| FaxNumber: | 8014673725 | ||||||||
| Practice Location | |||||||||
| Address1: | 1726 BUCKLEY LN | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846065031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013736562 | ||||||||
| FaxNumber: | 8013759225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2006 | ||||||||
| LastUpdateDate: | 01/07/2010 | ||||||||
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| AuthorizedOfficialLastName: | FRITZ | ||||||||
| AuthorizedOfficialFirstName: | VALERIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 8014873276 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MA LSAC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 11450 | UT | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.