Provider Demographics
NPI:1245690700
Name:HOPE NETWORK
Entity type:Organization
Organization Name:HOPE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE MGMT.
Authorized Official - Prefix:MS
Authorized Official - First Name:RONEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-213-1803
Mailing Address - Street 1:175 N GROESBECK HWY
Mailing Address - Street 2:UNIT 175-F
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-1562
Mailing Address - Country:US
Mailing Address - Phone:586-627-0024
Mailing Address - Fax:586-627-0027
Practice Address - Street 1:175 NORTH GROESBECK
Practice Address - Street 2:UNIT 175F
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043
Practice Address - Country:US
Practice Address - Phone:586-627-0024
Practice Address - Fax:586-627-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801082542251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health