| Organization Name: | HIDDEN HOPE RESIDENTIAL |
| NPI Number: | 1093122368 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN WRIGHT (ADMINISTRATOR) |
| Mailing Address: | 12640 14th St Yucaipa |
| State: | CA US |
| Postal Code: | 923991855 |
| Phone Number: | 6267979977 |
| Fax Number: | 6268442977 |
| NPI Enumeration Date: | 07/17/2014 |
| NPI Last Update Date: | 07/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 360100AP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |