Provider Demographics
NPI:1700232261
Name:HOPEFUL BEGINNINGS LLC
Entity Type:Organization
Organization Name:HOPEFUL BEGINNINGS LLC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LANE-BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LISW-S
Authorized Official - Phone:419-591-8093
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-0147
Mailing Address - Country:US
Mailing Address - Phone:419-591-8093
Mailing Address - Fax:
Practice Address - Street 1:1012 RALSTON AVE
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-1397
Practice Address - Country:US
Practice Address - Phone:419-591-8093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00007759-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0161032Medicaid