Provider Demographics
NPI:1295015360
Name:HOPE NETWORK REHABILIATION SERVICES
Entity Type:Organization
Organization Name:HOPE NETWORK REHABILIATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOCATIONAL INDEP. LIVING INSTRUCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:KRUCEK
Authorized Official - Suffix:
Authorized Official - Credentials:AA
Authorized Official - Phone:616-940-0040
Mailing Address - Street 1:1490 E BELTLINE AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4336
Mailing Address - Country:US
Mailing Address - Phone:616-940-0040
Mailing Address - Fax:616-940-8151
Practice Address - Street 1:1490 E BELTLINE AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-4336
Practice Address - Country:US
Practice Address - Phone:616-940-0040
Practice Address - Fax:616-940-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center