Organization
ABUNDANT LIFE MINISTRIES-HOPE HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA SHANK (CEO)
(386) 597-2861
Entity
Organization
Contact information
Practice address
25 OLD KINGS RD N STE 7B, PALM COAST, FL 32137-8245
(386) 597-2861
Mailing address
PO BOX 354925, PALM COAST, FL 32135-4925
(386) 597-2861
(386) 447-4580
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/19/2018
Last updated
05/31/2019
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