Healthcare Provider Details

I. General information

NPI: 1982585261
Provider Name (Legal Business Name): HOPE INSTITUTE OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 CHARNELTON ST
EUGENE OR
97401-3906
US

IV. Provider business mailing address

1070 COMMERCE DR STE 102
PERRYSBURG OH
43551-5231
US

V. Phone/Fax

Practice location:
  • Phone: 458-219-2919
  • Fax:
Mailing address:
  • Phone: 419-482-8382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DEREK JOSHUA LEE
Title or Position: CEO
Credential: PHD, LPCC-S
Phone: 419-290-4722