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NPI Code Detail

MEDICARE: NEW HOPE COMMUNITY SERVICE CENTER

MEDICARE: NEW HOPE COMMUNITY SERVICE 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
1251S00000XCommunity/Behavioral Health AgencyA-6701-0002-AIL

General Provider Information

NPI Number : 1356519714
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW HOPE COMMUNITY SERVICE CENTER
Provider Business Mailing Address
First Line : 2559 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-1751
Country : US
Telephone Number : 773-737-9555
Fax Number : 773-737-0401
Provider Business Practice Location Address
First Line : 2559 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60652-1751
Country : US
Telephone Number : 773-737-9555
Fax Number : 773-737-0401
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. BRENDA J. GOLDEN
Credential : MHS
Telephone Number : 773-737-9555
Provider Enumeration Date : 02/19/2008
Last Update Date : 02/19/2008

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Directions to “NEW HOPE COMMUNITY SERVICE CENTER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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