Provider Demographics
NPI:1609952373
Name:HOUSE OF HOPE, INC.
Entity Type:Organization
Organization Name:HOUSE OF HOPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:DORIS-MANTHY
Authorized Official - Last Name:KREUTZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-385-7600
Mailing Address - Street 1:PO BOX 291
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-0291
Mailing Address - Country:US
Mailing Address - Phone:507-385-7600
Mailing Address - Fax:507-720-6929
Practice Address - Street 1:1429 3RD AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-2905
Practice Address - Country:US
Practice Address - Phone:507-625-4536
Practice Address - Fax:507-625-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN801093-2-CDT324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1609952373OtherNPI # RESIDENTIAL
MN265856900OtherMHCP PROVIDER NUMBER
MN8107HOOtherBC/BS CONTRACT PROV NUM