Provider Demographics
NPI:1851425748
Name:HOPE HAVEN AREA DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:HOPE HAVEN AREA DEVELOPMENT CENTER
Other - Org Name:NORTHWOOD GROUP HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FISCAL MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PARMETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-754-4689
Mailing Address - Street 1:3711 LENNOX AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-2233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:319-754-0045
Practice Address - Street 1:2209 NORTHERN DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-2256
Practice Address - Country:US
Practice Address - Phone:319-754-4589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities