| Hopeallianz Inc | |
|
4205 Lancaster Ln N Suite 111 Plymouth MN 55441-1700 | |
| (763) 546-6624 | |
| (763) 332-5006 |
| Full Name | Hopeallianz Inc |
|---|---|
| Speciality | Social Worker |
| Location | 4205 Lancaster Ln N, Plymouth, Minnesota |
| Authorized Official Name and Position | Jody L Friesen Grande (CEO) |
| Authorized Official Contact | 7635466624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hopeallianz Inc 4205 Lancaster Ln N Suite 111 Plymouth MN 55441-1700 Ph: (763) 546-6624 | Hopeallianz Inc 4205 Lancaster Ln N Suite 111 Plymouth MN 55441-1700 Ph: (763) 546-6624 |
| NPI Number | 1710985114 |
|---|---|
| Provider Enumeration Date | 07/09/2005 |
| Last Update Date | 10/24/2013 |
| Medicare PECOS PAC ID | 9830186535 |
|---|---|
| Medicare Enrollment ID | O20040426001746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710985114 | NPI | - | NPPES |
| 475522700 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 10662 (Minnesota) | Primary |
| Provider Name | Jody L Grande |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801894209 PECOS PAC ID: 3274520994 Enrollment ID: I20040427000520 |
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