Provider Demographics
NPI:1144376989
Name:NEW HOPE CAROLINAS
Entity Type:Organization
Organization Name:NEW HOPE CAROLINAS
Other - Org Name:NEW HOPE CAROLINAS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CUPP
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:803-328-9300
Mailing Address - Street 1:7895 FOXCROFT LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-3878
Mailing Address - Country:US
Mailing Address - Phone:704-455-6433
Mailing Address - Fax:
Practice Address - Street 1:7895 FOXCROFT LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-3878
Practice Address - Country:US
Practice Address - Phone:704-455-6433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3106323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility