HOPE HOUSE OF ITASCA COUNTY, INC. (NPI# 1962509364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962509364 |
| Entity Type | Organization |
| Organization Name | HOPE HOUSE OF ITASCA COUNTY, INC. |
| Practice Address |
604 S Pokegama Ave Grand Rapids MN 55744-3831 |
| Practice Telephone | 2183261443 |
| Practice Fax Number | 2183264390 |
| Mailing Telephone | 2183261443 |
| Mailing Fax Number | 2183264390 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. SUSAN LYNN MARCHEL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2183279944 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 801078 | MN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 798555000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851496368 | Hope House of Itasca County, Inc. | Substance Abuse Rehabilitation Facility | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2006-09-13 |
| Street Address |
604 S POKEGAMA AVE |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744-3831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467779553 | Warren Goggleye | Counselor | 604 S Pokegama Ave, Grand Rapids, MN 55744-3831 | 2010-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235789074 | Green Castle Recovery Centers, LLC. | Substance Abuse Rehabilitation Facility | 233 Fulton St E Ste 101, Grand Rapids, MI 49503-3262 | 2019-09-13 |
| 1588918841 | Edward A Booker Jr. | Substance Abuse Rehabilitation Facility | 1740 Willard Ave Se, Grand Rapids, MI 49507-2662 | 2012-11-07 |
| 1609129782 | Ronald Debose | Substance Abuse Rehabilitation Facility | 1139 Thomas St Se, Grand Rapids, MI 49506-2665 | 2012-10-26 |
| 1427115336 | Our Hope Association | Substance Abuse Rehabilitation Facility | 324 Lyon St Ne, Grand Rapids, MI 49503-5607 | 2007-01-02 |
| 1104986603 | Project Rehab | Substance Abuse Rehabilitation Facility | 200 Eastern Ave Se, Grand Rapids, MI 49503-4735 | 2006-12-12 |
| 1851496368 | Hope House of Itasca County, Inc. | Substance Abuse Rehabilitation Facility | 2086 Ridgeway Dr, Grand Rapids, MN 55744-4421 | 2006-09-13 |
| 1891259339 | Hope Network Recovery | Substance Abuse Rehabilitation Facility | 3210 Eagle Run Dr Ne, Grand Rapids, MI 49525-7051 | 2019-01-29 |
| 1841791357 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 300 68th Street Se, Grand Rapids, MI 49548 | 2018-02-21 |
| 1467844258 | Green Castle Recovery Centers, LLC. | Substance Abuse Rehabilitation Facility | 540 Cherry St Se, Grand Rapids, MI 49503-4748 | 2015-03-03 |
| 1912305459 | Fawn Cichoski | Substance Abuse Rehabilitation Facility | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2014-12-16 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.