Provider Demographics
NPI:1871921346
Name:BLUE HOPE SUPPORTIVE CARE
Entity type:Organization
Organization Name:BLUE HOPE SUPPORTIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHARMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:973-868-9640
Mailing Address - Street 1:260 NESBIT TER
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1773
Mailing Address - Country:US
Mailing Address - Phone:973-868-9640
Mailing Address - Fax:
Practice Address - Street 1:260 NESBIT TER
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1773
Practice Address - Country:US
Practice Address - Phone:973-868-9640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health