Provider Demographics
NPI:1942079694
Name:HOPE ADULT TREATMENT MEDICAL CENTER LLC
Entity type:Organization
Organization Name:HOPE ADULT TREATMENT MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:253-208-9728
Mailing Address - Street 1:19020 B ST E UNIT B
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-8310
Mailing Address - Country:US
Mailing Address - Phone:253-208-9728
Mailing Address - Fax:
Practice Address - Street 1:19020 B ST E UNIT B
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8310
Practice Address - Country:US
Practice Address - Phone:253-208-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health