Healthcare Provider Details

I. General information

NPI: 1134354475
Provider Name (Legal Business Name): HOUSE OF NEW HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2009
Last Update Date: 05/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8135 MOUNT VERNON RD
ST LOUISVILLE OH
43071-9670
US

IV. Provider business mailing address

8135 MOUNT VERNON RD
ST LOUISVILLE OH
43071-9670
US

V. Phone/Fax

Practice location:
  • Phone: 740-345-5437
  • Fax: 888-810-6162
Mailing address:
  • Phone: 740-345-5437
  • Fax: 888-810-6162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY R. GREENE
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 740-321-1253