Organization Name: | HOPE HOUSE OF ITASCA COUNTY, INC. |
NPI Number: | 1962509364 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN LYNN MARCHEL (EXECUTIVE DIRECTOR) |
Mailing Address: | 604 S Pokegama Ave Grand Rapids |
State: | MN US |
Postal Code: | 557443831 |
Phone Number: | 2183261443 |
Fax Number: | 2183264390 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | 801078 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |