NPIMap

Organization Active NPI

Hope Behavioral Services of Volusia LLC

  • Clinic/Center
  • Daytona Beach, FL
National Provider Identifier
1891317525
Registry record updated May 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HOPE BEHAVIORAL SERVICES OF VOLUSIA LLC
Practice address
210 S Beach St Ste 200
Daytona Beach, FL 32114-4433
Phone
(386) 383-4562
Fax
(386) 256-2320
NPI assigned
May 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Willie Wallace
Title
Owner/Ceo
Phone
(386) 383-4562

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

210 S Beach St Ste 200
Daytona Beach, FL 32114-4433

Mailing address

210 S Beach St Ste 200
Daytona Beach, FL 32114-4433
Phone (386) 383-4562

Other identifiers 1

IdentifierTypeStateIssuer
106519500MedicaidFL

National Provider Directory

National Provider Directory

Locations

140 S Beach St
Ste 301
Daytona Beach, FL 32114
Phone (347) 974-1142

210 S Beach St
Ste 200
Daytona Beach, FL 32114
Phone (386) 383-4562

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746835200000",
    "number": "1891317525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S BEACH ST STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144433",
            "telephone_number": "386-383-4562",
            "fax_number": "386-256-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S BEACH ST STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144433",
            "telephone_number": "386-383-4562",
            "fax_number": "386-256-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE BEHAVIORAL SERVICES OF VOLUSIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2025-05-10",
        "certification_date": "2025-05-10",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "386-383-4562",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106519500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.