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General NPI Number Information
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NPI Number | 1326572447
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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 | 04/14/2017
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 950 W MONROE ST
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City | JACKSON
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State | MI
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Zip | 49202-2079
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Country | US
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Telephone | 517-320-9163
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Fax |
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Provider Business Mailing Address
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Address Line | 1537 N HAGADORN RD
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City | EAST LANSING
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State | MI
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Zip | 48823-2385
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Country | US
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Telephone | 517-331-7256
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER
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Name | MR. CEDRIC ANDRE GRIFFIN
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Credential |
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Telephone | 517-599-7165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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