Provider Demographics
NPI:1679684351
Name:NEW HOPE FAMILY YOUTH RELATIONS, INC.
Entity Type:Organization
Organization Name:NEW HOPE FAMILY YOUTH RELATIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RENNA
Authorized Official - Middle Name:DEMETRICE
Authorized Official - Last Name:EBRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-218-8536
Mailing Address - Street 1:601 N MECHANIC ST
Mailing Address - Street 2:SUITE # 126
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-1455
Mailing Address - Country:US
Mailing Address - Phone:252-218-8536
Mailing Address - Fax:757-562-1262
Practice Address - Street 1:601 N MECHANIC ST
Practice Address - Street 2:SUITE # 126
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1455
Practice Address - Country:US
Practice Address - Phone:252-218-8536
Practice Address - Fax:757-562-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010269415Medicaid