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Organization

HOPE NETWORK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS LORI JO KRZCIOK LPN (PROGRAM NURSE)
(616) 940-0040
Entity
Organization

Contact information

Practice address
1492 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 940-0040
(616) 940-1055
Mailing address
1492 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 940-0040
(616) 940-1055

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
4703093649
MI

Other

Enumeration date
12/29/2010
Last updated
12/29/2010
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