Provider Demographics
NPI:1619217353
Name:HOPE NETWORK
Entity Type:Organization
Organization Name:HOPE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRISIS SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-648-4659
Mailing Address - Street 1:2301 VALLEYWOOD DR SE
Mailing Address - Street 2:APT G1
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7745
Mailing Address - Country:US
Mailing Address - Phone:517-648-4659
Mailing Address - Fax:
Practice Address - Street 1:385 LEONARD ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1129
Practice Address - Country:US
Practice Address - Phone:616-454-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-17
Last Update Date:2013-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801087737320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness