Provider Demographics
NPI:1497272884
Name:NEW HOPE COMMUNITY SERVICE CENTER
Entity Type:Organization
Organization Name:NEW HOPE COMMUNITY SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MHS/MAC/CAADC/MAATP
Authorized Official - Phone:773-737-9555
Mailing Address - Street 1:2559 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-1751
Mailing Address - Country:US
Mailing Address - Phone:773-737-9555
Mailing Address - Fax:773-737-0401
Practice Address - Street 1:2559 W 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1751
Practice Address - Country:US
Practice Address - Phone:773-737-9555
Practice Address - Fax:773-737-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy