Provider Demographics
NPI:1174085203
Name:NEW HOPE RECOVERY LLC
Entity type:Organization
Organization Name:NEW HOPE RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TIN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-365-5137
Mailing Address - Street 1:2503 BUSH RIDGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-5885
Mailing Address - Country:US
Mailing Address - Phone:502-365-5137
Mailing Address - Fax:502-290-2839
Practice Address - Street 1:2503 BUSH RIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-5885
Practice Address - Country:US
Practice Address - Phone:502-365-5137
Practice Address - Fax:502-290-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-06
Last Update Date:2019-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty