Healthcare Provider Details
I. General information
NPI: 1447507082
Provider Name (Legal Business Name): NEW HOPE SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2012
Last Update Date: 12/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1623 W NEW HOPE DR
CEDAR PARK TX
78613-6018
US
IV. Provider business mailing address
410 MONMOUTH AVE SUITE 130
LAKEWOOD NJ
08701-3711
US
V. Phone/Fax
- Phone: 512-259-3999
- Fax: 512-259-4414
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name:
MENDY
SHAPIRO
Title or Position: MANAGER
Credential:
Phone: 732-961-9000