Healthcare Provider Details

I. General information

NPI: 1063642841
Provider Name (Legal Business Name): NEW HOPE COMMUNITY SERVICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9050 W 81ST ST STE 400
JUSTICE IL
60458-9800
US

IV. Provider business mailing address

9050 W 81ST ST STE 400
JUSTICE IL
60458-9800
US

V. Phone/Fax

Practice location:
  • Phone: 773-737-9555
  • Fax:
Mailing address:
  • Phone: 773-737-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number36383128
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: WANDA DENISE SMITH
Title or Position: DIRECTOR OF CODING AND COMPLIANCE
Credential:
Phone: 331-643-5238