Healthcare Provider Details

I. General information

NPI: 1184705576
Provider Name (Legal Business Name): NEW HOPE VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 E 18TH ST
CARROLL IA
51401-1833
US

IV. Provider business mailing address

1211 E 18TH ST PO BOX 887
CARROLL IA
51401-1833
US

V. Phone/Fax

Practice location:
  • Phone: 712-792-5500
  • Fax: 712-792-9944
Mailing address:
  • Phone: 712-792-5500
  • Fax: 712-792-9944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License NumberIMR-734
License Number StateIA

VIII. Authorized Official

Name: FRANK HERMSEN
Title or Position: CEO
Credential:
Phone: 712-792-5500