Provider Demographics
NPI:1083386809
Name:NEW HOPE ADDICTION RECOVERY, LLC
Entity Type:Organization
Organization Name:NEW HOPE ADDICTION RECOVERY, LLC
Other - Org Name:NEW HOPE ADDICTION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:Z
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-884-2777
Mailing Address - Street 1:1000 CHINABERRY DR STE 1003
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2463
Mailing Address - Country:US
Mailing Address - Phone:318-550-5490
Mailing Address - Fax:318-550-5489
Practice Address - Street 1:7330 FERN AVE STE 1003
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4988
Practice Address - Country:US
Practice Address - Phone:318-550-5490
Practice Address - Fax:318-550-5489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty