Hope House of Itasca County, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

801078 Issued in MN

Legal business name

HOPE HOUSE OF ITASCA COUNTY, INC.

Practice address

2002 Cromell Dr
Grand Rapids, MN 55744-3571

Phone

(218) 326-1443

Fax

(218) 326-4390

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Susan Lynn Marchel

Title

Executive Director

Phone

(218) 327-9944

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Hope House of Itasca County Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Hope House of Itasca County, Inc.

  dba Pear Lake Women's Facility

  • Substance Abuse Rehabilitation Facility
  • Grand Rapids, MN
  • NPI 1851496368
  NPD tax ID
• Pear Lake Women's Facility - Outpatient

  • Addiction (Substance Use Disorder) Counselor
  • Grand Rapids, MN
  • NPI 1225357437
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Warren Goggleye, CD

  • Mental Health Counselor
  • Grand Rapids, MN
  • NPI 1467779553
  NPD (past)
• Mischelle Louise Vietanen, PSY.D.

  • Clinical Psychologist
  • Grand Rapids, MN
  • NPI 1548694847
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1962509364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 CROMELL DR",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443571",
            "telephone_number": "218-326-1443",
            "fax_number": "218-326-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 CROMELL DR",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443571",
            "telephone_number": "218-326-1443",
            "fax_number": "218-326-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE HOUSE OF ITASCA COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "MARCHEL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-327-9944",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "801078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "798555000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Hofstad
• Stacy Kate Friesen Holl, DO
• Stephanie Christine Holthus
• Elizabeth Kate Hongo, LADC
• Hope House of Itasca County, Inc. (Pear Lake Women's Facility)
• Lauren Hopp
• Horseshoe Surgery Center, LLC (Lakewood Surgery Center)
• Denise Ann Hove, CCC/AUD
• Christina Marie Hubred, A D.T., DH
• Kerrie Rae Humble, MSW, LICSW

• Substance Abuse Rehabilitation Facility in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.