Provider Demographics
NPI:1174756332
Name:GOOD HOPE FAMILY SERVICE LLC
Entity type:Organization
Organization Name:GOOD HOPE FAMILY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:RHONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-465-2350
Mailing Address - Street 1:PO BOX 273
Mailing Address - Street 2:
Mailing Address - City:LILESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28091-0273
Mailing Address - Country:US
Mailing Address - Phone:704-465-2350
Mailing Address - Fax:704-465-2351
Practice Address - Street 1:201 W MORGAN ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2683
Practice Address - Country:US
Practice Address - Phone:704-465-2350
Practice Address - Fax:704-465-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization