Provider Demographics
NPI:1245574722
Name:NEW HOPE CBRF, INC.
Entity Type:Organization
Organization Name:NEW HOPE CBRF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-720-1551
Mailing Address - Street 1:P.O. BOX 686
Mailing Address - Street 2:133 W ELM STREET
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-0686
Mailing Address - Country:US
Mailing Address - Phone:715-720-1551
Mailing Address - Fax:715-720-1505
Practice Address - Street 1:133 W ELM ST
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-1826
Practice Address - Country:US
Practice Address - Phone:715-720-1551
Practice Address - Fax:715-720-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0012152320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness