| Organization Name: | MIND OF HOPE COMMUNITY LIVING PROGRAM, INC |
| NPI Number: | 1306141718 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MELVIN R THOMAS (PRESIDENT & CEO) |
| Mailing Address: | 7190 Nc Highway 11 Willard |
| State: | NC US |
| Postal Code: | 284787062 |
| Phone Number: | 9104417080 |
| Fax Number: | 9105525006 |
| NPI Enumeration Date: | 01/14/2011 |
| NPI Last Update Date: | 07/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2926 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |