Provider Demographics
NPI:1184334278
Name:A BLUE HOPE , INC
Entity type:Organization
Organization Name:A BLUE HOPE , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-291-1695
Mailing Address - Street 1:14331 SW 120TH ST STE 214
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7297
Mailing Address - Country:US
Mailing Address - Phone:561-462-0686
Mailing Address - Fax:561-462-0685
Practice Address - Street 1:14331 SW 120TH ST STE 214
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7297
Practice Address - Country:US
Practice Address - Phone:561-462-0686
Practice Address - Fax:561-462-0685
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A BLUE HOPE , INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty