Organization
LIVING HOPE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN NIZEYE JENSON (CEO)
(207) 699-6134
Entity
Organization
Contact information
Practice address
5251 W CAMPBELL AVE STE 208, PHOENIX, AZ 85031-1719
(207) 966-6134
Mailing address
5251 W CAMPBELL AVE STE 208, PHOENIX, AZ 85031-1719
(207) 966-6134
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
01/29/2024
Last updated
07/21/2025
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