Provider Demographics
NPI:1659438349
Name:NEW HOPE AGENCY
Entity Type:Organization
Organization Name:NEW HOPE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WALLINGFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-265-1859
Mailing Address - Street 1:162 NORMANS CAMP RD
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-9236
Mailing Address - Country:US
Mailing Address - Phone:859-748-5000
Mailing Address - Fax:859-748-5500
Practice Address - Street 1:162 NORMANS CAMP RD
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-9236
Practice Address - Country:US
Practice Address - Phone:859-748-5000
Practice Address - Fax:859-748-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3300074600320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3300074600Medicaid