| Hope Network West Michigan | |
|
253 W Gardner St Sparta MI 49345-1722 | |
| (616) 383-1046 | |
| Not Available |
| Full Name | Hope Network West Michigan |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Location | 253 W Gardner St, Sparta, Michigan |
| Authorized Official Name and Position | Timothy T Becker (COO) |
| Authorized Official Contact | 6163018000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Network West Michigan 3075 Orchard Vista Dr Se Grand Rapids MI 49546-7069 Ph: (616) 301-8000 | Hope Network West Michigan 253 W Gardner St Sparta MI 49345-1722 Ph: (616) 383-1046 |
| NPI Number | 1679558670 |
|---|---|
| Provider Enumeration Date | 12/13/2005 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Medicare PECOS PAC ID | 5395837603 |
|---|---|
| Medicare Enrollment ID | O20070816000328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679558670 | NPI | - | NPPES |
| Provider Name | Kiran Kk Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306945035 PECOS PAC ID: 2466545363 Enrollment ID: I20070910000178 |
| Provider Name | Yolanda D Giles |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1942382502 PECOS PAC ID: 1254408446 Enrollment ID: I20080930000689 |
| Provider Name | Jillaine Ruppel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780816520 PECOS PAC ID: 9931255106 Enrollment ID: I20090914000607 |
| Provider Name | Jessica R Hamp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679909642 PECOS PAC ID: 6507081940 Enrollment ID: I20140627001089 |
| Provider Name | Paige A Gillespie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194116376 PECOS PAC ID: 2163742792 Enrollment ID: I20150522000535 |
| Provider Name | Amanda L Ledford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265823504 PECOS PAC ID: 3678876141 Enrollment ID: I20160119000095 |
| Provider Name | Leana M Tank |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083087464 PECOS PAC ID: 3476859224 Enrollment ID: I20160304001041 |
| Provider Name | Megan Pena |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114170800 PECOS PAC ID: 9436443595 Enrollment ID: I20160811002460 |
| Provider Name | Aybianeth Carolina Smart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104366996 PECOS PAC ID: 7214204213 Enrollment ID: I20170523001377 |
| Provider Name | Stephanie Theresa Leone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922202233 PECOS PAC ID: 4385917616 Enrollment ID: I20170907001678 |
| Provider Name | Stephanie Y Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912414756 PECOS PAC ID: 7911260484 Enrollment ID: I20180416000184 |
| Provider Name | Myele L Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164998431 PECOS PAC ID: 3971848136 Enrollment ID: I20181218000072 |
| Provider Name | Jena K Bartholomy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1376004903 PECOS PAC ID: 9638402050 Enrollment ID: I20211011000320 |
| Provider Name | Terry A Hunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588321020 PECOS PAC ID: 6204215692 Enrollment ID: I20220615000431 |
| Provider Name | Michael W Victor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508504986 PECOS PAC ID: 2264812692 Enrollment ID: I20220701001821 |
| Provider Name | Claire Harrison |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801503099 PECOS PAC ID: 0749650117 Enrollment ID: I20221229000124 |
| Provider Name | Deola Saheed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972008381 PECOS PAC ID: 5799185989 Enrollment ID: I20230211000309 |
| Provider Name | Jacqulyn Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285092445 PECOS PAC ID: 0244695963 Enrollment ID: I20230503000572 |
| Provider Name | Kala Pozivilko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669042990 PECOS PAC ID: 0345638052 Enrollment ID: I20230712003074 |
| Provider Name | Kristin L Meyering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497432108 PECOS PAC ID: 6406218734 Enrollment ID: I20230817002040 |
| Provider Name | Amanda M Waidelich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700375615 PECOS PAC ID: 9739538323 Enrollment ID: I20231207002355 |
| Provider Name | Matthew Allen Dearlove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023494317 PECOS PAC ID: 6204279649 Enrollment ID: I20240213001439 |
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