Healthcare Provider Details

I. General information

NPI: 1194954115
Provider Name (Legal Business Name): NEW HOPE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2009
Last Update Date: 07/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 COMMERCE ST
MANNING SC
29102-2637
US

IV. Provider business mailing address

232 COMMERCE ST
MANNING SC
29102-2637
US

V. Phone/Fax

Practice location:
  • Phone: 803-433-1777
  • Fax: 803-433-1777
Mailing address:
  • Phone: 803-433-1777
  • Fax: 803-433-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number3306
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. EDRENA CONYERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 803-433-1777