# MITSRAIN'S HOUSE OF HOPE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780293654
- **Authorized official:** MRS. DEBORAH C ROUSSEAU PEER SUPPORT (SPECIALIST)
- **Authorized official phone:** (646) 899-5270

## Contact information

- **Practice address:** 5744 N 41ST AVE, PHOENIX, AZ 85019-1814
- **Practice address phone:** (646) 899-5270
- **Mailing address:** 5744 N 41ST AVE, PHOENIX, AZ 85019-1814
- **Mailing address phone:** (646) 899-5270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2020
- **Last updated:** 07/27/2020