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NPI Code Detail

MEDICARE: HOPE INSTITUTE OF AMERICA

MEDICARE: HOPE INSTITUTE OF AMERICA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1336822824
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOPE INSTITUTE OF AMERICA
Provider Business Mailing Address
First Line : 1070 COMMERCE DRIVE
Second Line : BUILDING ONE, SUITE 101
City : PERRYSBURG
State : OH
Zip : 43551-5231
Country : US
Telephone Number : 419-482-8382
Fax Number :
Provider Business Practice Location Address
First Line : 1070 COMMERCE DR
Second Line : BLDG 1, STE 101
City : PERRYSBURG
State : OH
Zip : 43551-5231
Country : US
Telephone Number : 419-482-8382
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. DEREK J LEE
Credential : LPCC-S
Telephone Number : 419-290-4722
Provider Enumeration Date : 08/10/2023
Last Update Date : 08/13/2024

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Directions to “HOPE INSTITUTE OF AMERICA ” Practice Location

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