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General NPI Number Information
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NPI Number | 1144660341
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Entity Type | Organization
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Legal Business Name | HOPE NETWORK
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 07/02/2013
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Provider Practice Location Address
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Address Line | 1425 FREMONT AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-3017
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Country | US
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Telephone | 616-742-2644
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 FREMONT AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-3017
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Country | US
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Telephone | 616-742-2644
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Fax |
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Authorized Official
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Title or Position | THERAPEUTIC RECREATIONAL AIDE
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Name | LAURA S PRICE
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Credential |
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Telephone | 616-742-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State | MI
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