Provider Demographics
NPI:1649565615
Name:HOPE NETWORK REHAB SERVICE
Entity type:Organization
Organization Name:HOPE NETWORK REHAB SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB ASST
Authorized Official - Prefix:
Authorized Official - First Name:LOVEY
Authorized Official - Middle Name:JONELLE
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-325-5130
Mailing Address - Street 1:212 GARFIELD AVE NW APT 1
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-5436
Mailing Address - Country:US
Mailing Address - Phone:616-325-5130
Mailing Address - Fax:
Practice Address - Street 1:1490 E BELTLINE AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-4336
Practice Address - Country:US
Practice Address - Phone:616-940-0040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Multi-Specialty