Provider Demographics
NPI:1053924803
Name:FOUNDATION OF HOPE MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FOUNDATION OF HOPE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDDICK
Authorized Official - Suffix:
Authorized Official - Credentials:BA, QMHP-A
Authorized Official - Phone:757-386-1873
Mailing Address - Street 1:857 HARDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9215
Mailing Address - Country:US
Mailing Address - Phone:757-386-1873
Mailing Address - Fax:
Practice Address - Street 1:857 HARDWOOD DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-9215
Practice Address - Country:US
Practice Address - Phone:757-386-1873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health