Provider Demographics
NPI:1871903948
Name:HOPE HEALTH SYSTEMS
Entity type:Organization
Organization Name:HOPE HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLANRELE
Authorized Official - Middle Name:
Authorized Official - Last Name:FADIORA
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:410-865-7549
Mailing Address - Street 1:6707 WHITESTONE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4140
Mailing Address - Country:US
Mailing Address - Phone:410-265-8737
Mailing Address - Fax:
Practice Address - Street 1:6707 WHITESTONE RD STE 106
Practice Address - Street 2:
Practice Address - City:WOODLAWN
Practice Address - State:MD
Practice Address - Zip Code:21207-4140
Practice Address - Country:US
Practice Address - Phone:410-265-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14545251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD222000800Medicaid
MD214619Medicare PIN