Provider Demographics
NPI:1225761992
Name:HOPE RECOVERY SERVICES
Entity Type:Organization
Organization Name:HOPE RECOVERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:LADC, NCAC II, SAP
Authorized Official - Phone:507-382-2584
Mailing Address - Street 1:1530 BELLOWS ST APT 111
Mailing Address - Street 2:
Mailing Address - City:W SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3342
Mailing Address - Country:US
Mailing Address - Phone:507-382-2584
Mailing Address - Fax:
Practice Address - Street 1:1530 BELLOWS ST APT 111
Practice Address - Street 2:
Practice Address - City:W SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3342
Practice Address - Country:US
Practice Address - Phone:507-382-2584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1336556349Medicaid