| House Of Hope | |
|
1744 2nd Ave Se Cedar Rapids IA 52403-2306 | |
| (319) 366-4673 | |
| Not Available |
| Full Name | House Of Hope |
|---|---|
| Speciality | Clinic/Center |
| Location | 1744 2nd Ave Se, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Tarra Lynn Stangl (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3193664373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| House Of Hope 1744 2nd Ave Se Cedar Rapids IA 52403-2306 Ph: (319) 366-4673 | House Of Hope 1744 2nd Ave Se Cedar Rapids IA 52403-2306 Ph: (319) 366-4673 |
| NPI Number | 1326564527 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 08/05/2021 |
| Medicare PECOS PAC ID | 7911444070 |
|---|---|
| Medicare Enrollment ID | O20240807000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326564527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Diana Sue Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902352412 PECOS PAC ID: 2365989423 Enrollment ID: I20240807000439 |
| Provider Name | Sarah E Heller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710301916 PECOS PAC ID: 5092238410 Enrollment ID: I20250326002911 |
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