Provider Demographics
NPI:1871757658
Name:GIFT OF HOPE &HEALING INC
Entity type:Organization
Organization Name:GIFT OF HOPE &HEALING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:AWANYAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-367-4814
Mailing Address - Street 1:8455 S VAN NESS AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-1519
Mailing Address - Country:US
Mailing Address - Phone:323-565-2043
Mailing Address - Fax:323-565-2044
Practice Address - Street 1:8455 S VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-1519
Practice Address - Country:US
Practice Address - Phone:323-565-2043
Practice Address - Fax:323-565-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility