MEDICARE: NEW HOPE CARE CENTER

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	:	1316286784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HOPE CARE CENTER

Provider Business Mailing Address
First Line	:	5250 S RAINBOW BLVD UNIT 2008
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0631
Country	:	US
Telephone Number	:	702-327-0308
Fax Number	:

Provider Business Practice Location Address
First Line	:	5250 S RAINBOW BLVD UNIT 2008
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0631
Country	:	US
Telephone Number	:	702-327-0308
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOJISOLA BALOGUN
Credential	:	RN
Telephone Number	:	702-327-0308

Provider Enumeration Date	:	02/05/2013
Last Update Date	:	02/05/2013

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