Healthcare Provider Details

I. General information

NPI: 1609019678
Provider Name (Legal Business Name): NEW HOPE FAMILY AND YOUTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

102 S. WEST RAILROAD ST.
ENFIELD NC
27823-1300
US

IV. Provider business mailing address

102 S. WEST RAILROAD ST.
ENFIELD NC
27823-1300
US

V. Phone/Fax

Practice location:
  • Phone: 252-287-9218
  • Fax: 252-537-4559
Mailing address:
  • Phone: 252-287-9218
  • Fax: 252-537-4559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY WARD RICHARDSON
Title or Position: EXECUTIVE ADMINISTRATOR
Credential: M. ED.
Phone: 252-287-9218