MEDICARE: NEW HOPE AGENCY

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	3300074600	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659438349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HOPE AGENCY

Provider Business Mailing Address
First Line	:	162 NORMANS CAMP RD
Second Line	:
City	:	HARRODSBURG
State	:	KY
Zip	:	40330-9236
Country	:	US
Telephone Number	:	859-748-5000
Fax Number	:	859-748-5500

Provider Business Practice Location Address
First Line	:	162 NORMANS CAMP RD
Second Line	:
City	:	HARRODSBURG
State	:	KY
Zip	:	40330-9236
Country	:	US
Telephone Number	:	859-748-5000
Fax Number	:	859-748-5500

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. TERRY ALLEN WALLINGFORD
Credential	:
Telephone Number	:	859-265-1859

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	08/22/2020

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Directions to “NEW HOPE AGENCY ” Practice Location

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