Healthcare Provider Details

I. General information

NPI: 1912729591
Provider Name (Legal Business Name): GREATER NEW HOPE CHARITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 NW EASTMAN PKWY STE 175
GRESHAM OR
97030-3859
US

IV. Provider business mailing address

PO BOX 2112
FAIRVIEW OR
97024-1815
US

V. Phone/Fax

Practice location:
  • Phone: 971-340-0958
  • Fax:
Mailing address:
  • Phone: 971-340-0958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE SANDERS
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 971-340-0958