Healthcare Provider Details

I. General information

NPI: 1528356789
Provider Name (Legal Business Name): HOPE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 E BELTLINE AVE SE
GRAND RAPIDS MI
49506-4336
US

IV. Provider business mailing address

830 S OTTILLIA ST SE
GRAND RAPIDS MI
49507-3741
US

V. Phone/Fax

Practice location:
  • Phone: 616-940-0040
  • Fax:
Mailing address:
  • Phone: 517-803-1918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number2481067
License Number StateMI

VIII. Authorized Official

Name: MISS ERIN MARIE CUMMINGS
Title or Position: LIVING SKILLS STAFF
Credential:
Phone: 616-940-0040