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MAHALA'S HOPE, INC.
NPI 1073151874
Clinic/Center - Rehabilitation, Substance Use Disorder in Eden, WI

Active since December 12, 2019
N4590 US HIGHWAY 45, EDEN, WI 53019(920) 904-6445 Get Directions Write a Review

NPPES record last updated: December 12, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mahala's Hope, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAHALA'S HOPE, INC. (NPI 1073151874) is a healthcare organization registered as a rehabilitation, substance use disorder in Eden, Wisconsin and active in the NPI registry since December 2019. The organization lists Kristine Adelle Mendoza, Administrative Assistant, as its authorized official.

NPPES Registry Identity

NPI1073151874
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameMAHALA'S HOPE, INC.
Location AddressN4590 US HIGHWAY 45Eden, WI 53019-1212
Mailing AddressN4590 Us Highway 45Eden, WI 53019-1212 · (920) 904-6445
Phone(920) 904-6445
Organization SubpartNo
Authorized OfficialKristine Adelle MendozaAdministrative Assistant · (920) 904-6445
Enumeration DateDecember 12, 2019
✔ NPI 1073151874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
N4590 US HIGHWAY 45, Eden, WI 53019
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2137712

Mahala's Hope Inc · Eden, WI
Expired · Oct 2, 2025
CLIA Number52D2137712
Laboratory TypeCbrf For Substance Abuse
Certificate Effective DateOctober 3, 2023
Certificate Expiration DateOctober 2, 2025
Laboratory DirectorMs. Sandra J. Hardie
Laboratory Phone(920) 904-6445
Laboratory LocationMahala's Hope IncN4590 Hwy 45, Eden, WI 53019
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is MAHALA'S HOPE, INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1073151874, enumerated as an "organization" on December 12, 2019.

Where is the provider located?

The provider is located at N4590 US HIGHWAY 45 EDEN, WI 53019 and the phone number is (920) 904-6445.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.