Provider Demographics
NPI:1598894115
Name:NEW HOPE RESIDENTIAL CARE, INC
Entity Type:Organization
Organization Name:NEW HOPE RESIDENTIAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DILLIE
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-431-7336
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-0157
Mailing Address - Country:US
Mailing Address - Phone:573-431-7336
Mailing Address - Fax:573-431-7136
Practice Address - Street 1:2280 PIMVILLE RD
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:MO
Practice Address - Zip Code:63601-8146
Practice Address - Country:US
Practice Address - Phone:573-431-7336
Practice Address - Fax:573-431-7136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001871176322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO497456400Medicaid