Provider Demographics
NPI:1629113089
Name:HOPE NETWORK BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:HOPE NETWORK BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:BSPA
Authorized Official - Phone:616-774-8789
Mailing Address - Street 1:1242 BROADWAY AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-3207
Mailing Address - Country:US
Mailing Address - Phone:616-458-7519
Mailing Address - Fax:
Practice Address - Street 1:1242 BROADWAY AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-3207
Practice Address - Country:US
Practice Address - Phone:616-458-7519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness