Provider Demographics
NPI:1043670250
Name:BRIDGE OF HOPE PLUS CORP
Entity type:Organization
Organization Name:BRIDGE OF HOPE PLUS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:AB
Authorized Official - Phone:407-575-4636
Mailing Address - Street 1:PO BOX 452878
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34745-2878
Mailing Address - Country:US
Mailing Address - Phone:407-575-4636
Mailing Address - Fax:407-343-5599
Practice Address - Street 1:1300 KEVSTIN DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5843
Practice Address - Country:US
Practice Address - Phone:407-575-4636
Practice Address - Fax:407-343-5599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty