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General NPI Number Information
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NPI Number | 1013331438
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Entity Type | Organization
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Legal Business Name | NEW HOPE RESTORATIVE CARE, LLC
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 710 KING RD
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City | RIVERDALE
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State | GA
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Zip | 30274-2027
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Country | US
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Telephone | 770-991-7788
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Fax | 770-991-7727
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Provider Business Mailing Address
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Address Line | 8060 WEBB RD #741235
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City | RIVERDALE
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State | GA
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Zip | 30274-5502
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Country | US
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Telephone | 770-991-7788
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Fax | 770-991-7727
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Authorized Official
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Title or Position | OWNER
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Name | MRS. THELMA WASHINGTON
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Credential |
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Telephone | 470-331-6340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW006347
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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