MEDICARE: NEW HOPE COUNSELING SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1316118821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HOPE COUNSELING SERVICES, INC.

Provider Business Mailing Address
First Line	:	2064 EASTSIDE DR
Second Line	:	SUITE 517
City	:	CONYERS
State	:	GA
Zip	:	30013-1953
Country	:	US
Telephone Number	:	678-750-2301
Fax Number	:	678-750-1951

Provider Business Practice Location Address
First Line	:	2064 EASTSIDE DR
Second Line	:	SUITE 517
City	:	CONYERS
State	:	GA
Zip	:	30013-1953
Country	:	US
Telephone Number	:	678-750-2301
Fax Number	:	678-750-1951

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JOE ANDRE TUCK
Credential	:
Telephone Number	:	678-750-2301

Provider Enumeration Date	:	03/13/2008
Last Update Date	:	08/24/2008

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