Provider Demographics
NPI:1477703106
Name:NEW HOPE FOUNDATION FOR THE UNDERSERVED, INC.
Entity Type:Organization
Organization Name:NEW HOPE FOUNDATION FOR THE UNDERSERVED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:
Authorized Official - First Name:R.
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:LISH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:301-620-8700
Mailing Address - Street 1:10 N JEFFERSON ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3500
Mailing Address - Country:US
Mailing Address - Phone:301-696-8880
Mailing Address - Fax:
Practice Address - Street 1:10 N JEFFERSON ST
Practice Address - Street 2:SUITE 403
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3500
Practice Address - Country:US
Practice Address - Phone:301-696-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty