| Haven Of Hope, Pllc | |
|
1519 Florence Rd Ste 14 Killeen TX 76541-7903 | |
| (254) 371-4661 | |
| Not Available |
| Full Name | Haven Of Hope, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1519 Florence Rd Ste 14, Killeen, Texas |
| Authorized Official Name and Position | Angelia Jourdain (OWNER) |
| Authorized Official Contact | 2543714661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Haven Of Hope, Pllc 1519 Florence Rd Ste 14 Killeen TX 76541-7903 Ph: (254) 371-4661 | Haven Of Hope, Pllc 1519 Florence Rd Ste 14 Killeen TX 76541-7903 Ph: (254) 371-4661 |
| NPI Number | 1629668686 |
|---|---|
| Provider Enumeration Date | 01/24/2021 |
| Last Update Date | 01/24/2021 |
| Certification Date | 01/24/2021 |
| Medicare PECOS PAC ID | 0749628758 |
|---|---|
| Medicare Enrollment ID | O20240409003656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629668686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Angela Marie Jourdain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104341940 PECOS PAC ID: 1658719661 Enrollment ID: I20240409003768 |
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