Provider Demographics
NPI:1588225882
Name:HOPE RESTORED COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:HOPE RESTORED COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LADAWN
Authorized Official - Middle Name:NICHELLE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLPC
Authorized Official - Phone:616-239-2299
Mailing Address - Street 1:2180 44TH ST SE STE 302
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-5323
Mailing Address - Country:US
Mailing Address - Phone:616-239-2299
Mailing Address - Fax:
Practice Address - Street 1:2180 44TH ST SE STE 302
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-5323
Practice Address - Country:US
Practice Address - Phone:616-239-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty