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General NPI Number Information
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NPI Number | 1811330251
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Entity Type | Organization
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Legal Business Name | HOPE NETWORK - REHABILITATION SERVICES
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 1490 E BELTLINE AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-4336
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Country | US
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Telephone | 616-940-0040
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Fax | 616-940-8151
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Provider Business Mailing Address
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Address Line | 3075 ORCHARD VISTA DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7069
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Country | US
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Telephone | 616-301-8000
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. TIMOTHY T BECKER
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Credential |
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Telephone | 616-301-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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