Provider Demographics
NPI:1205326238
Name:HOPE HAVEN AREA DEVELOPMENT CENTER CORPORATION
Entity type:Organization
Organization Name:HOPE HAVEN AREA DEVELOPMENT CENTER CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR OF PROGRAMS
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-237-1308
Mailing Address - Street 1:828 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-4921
Mailing Address - Country:US
Mailing Address - Phone:319-237-1308
Mailing Address - Fax:319-754-0045
Practice Address - Street 1:828 N 7TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-4921
Practice Address - Country:US
Practice Address - Phone:319-237-1308
Practice Address - Fax:319-754-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services