Provider Demographics
NPI:1336822824
Name:HOPE INSTITUTE OF AMERICA
Entity Type:Organization
Organization Name:HOPE INSTITUTE OF AMERICA
Other - Org Name:THE HOPE INSTITUTE OF AMERICA, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:419-290-4722
Mailing Address - Street 1:1070 COMMERCE DRIVE
Mailing Address - Street 2:BUILDING ONE, SUITE 101
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5231
Mailing Address - Country:US
Mailing Address - Phone:419-482-8382
Mailing Address - Fax:
Practice Address - Street 1:1070 COMMERCE DR STE 102
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5231
Practice Address - Country:US
Practice Address - Phone:419-482-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty