| One Hope, Llc | |
|
2 Dove Way Cir Clinton MS 39056-3589 | |
| (601) 201-6862 | |
| Not Available |
| Full Name | One Hope, Llc |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 2 Dove Way Cir, Clinton, Mississippi |
| Authorized Official Name and Position | Adooree Michelle Tullar (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7692415146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| One Hope, Llc 1896 Hwy. 471 Brandon MS 39047 Ph: (769) 241-5146 | One Hope, Llc 2 Dove Way Cir Clinton MS 39056-3589 Ph: (601) 201-6862 |
| NPI Number | 1467987701 |
|---|---|
| Provider Enumeration Date | 04/24/2017 |
| Last Update Date | 06/05/2022 |
| Certification Date | 06/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467987701 | NPI | - | NPPES |
| 06354818 | Medicaid | MS | |
| 0898306 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (Mississippi) | Secondary |
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