Provider Demographics
NPI:1942750740
Name:HOPE NETWORK
Entity Type:Organization
Organization Name:HOPE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:LANGEREIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-780-6274
Mailing Address - Street 1:1127 WEALTHY ST SE
Mailing Address - Street 2:#3
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1598
Mailing Address - Country:US
Mailing Address - Phone:616-780-6274
Mailing Address - Fax:
Practice Address - Street 1:1127 WEALTHY ST SE
Practice Address - Street 2:#3
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1598
Practice Address - Country:US
Practice Address - Phone:616-780-6274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801100095305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization