Provider Demographics
NPI:1922083203
Name:HOPE NETWORK SOUTH
Entity Type:Organization
Organization Name:HOPE NETWORK SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TUINSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-301-8000
Mailing Address - Street 1:755 36TH ST SE
Mailing Address - Street 2:PO BOX 890
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49548-2319
Mailing Address - Country:US
Mailing Address - Phone:616-301-8000
Mailing Address - Fax:616-301-8010
Practice Address - Street 1:626 REED AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2971
Practice Address - Country:US
Practice Address - Phone:269-343-6355
Practice Address - Fax:269-343-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)