Healthcare Provider Details
I. General information
NPI: 1790009678
Provider Name (Legal Business Name): NEW HOPE HCS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2010
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7908 MODESTO DR
ARLINGTON TX
76001-6102
US
IV. Provider business mailing address
7908 MODESTO DR
ARLINGTON TX
76001-6102
US
V. Phone/Fax
- Phone: 817-703-9562
- Fax:
- Phone: 817-703-9562
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MARIE
M
OMOROGBE
Title or Position: OWNER
Credential:
Phone: 817-703-9562