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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
1261QP2400XPrison Health Clinic/Center

General Provider Information

NPI Number : 1427779586
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 : 708-737-0401
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 : 708-737-0401
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. BRENDA JOYCE GOLDEN
Credential : LASOP, MHS, CAADC
Telephone Number : 773-737-9555
Provider Enumeration Date : 09/07/2022
Last Update Date : 09/07/2022

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Directions to “NEW HOPE COMMUNITY SERVICE CENTER ” Practice Location

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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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