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General NPI Number Information
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NPI Number | 1245574722
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Entity Type | Organization
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Legal Business Name | NEW HOPE CBRF, INC.
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Dates
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Enumeration Date | 11/21/2012
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Last Update Date | 11/21/2012
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Provider Practice Location Address
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Address Line | 133 W ELM ST
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-1826
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Country | US
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Telephone | 715-720-1551
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Fax | 715-720-1505
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Provider Business Mailing Address
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Address Line | P.O. BOX 686 133 W ELM STREET
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-0686
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Country | US
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Telephone | 715-720-1551
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Fax | 715-720-1505
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHN C SCHULTZ
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Credential |
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Telephone | 715-720-1551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 0012152
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License Number State | WI
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