Provider Demographics
NPI:1710750815
Name:NEW VISION HOUSE OF HOPE, INC
Entity Type:Organization
Organization Name:NEW VISION HOUSE OF HOPE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:CSC-AD
Authorized Official - Phone:410-466-8558
Mailing Address - Street 1:33 S GAY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4039
Mailing Address - Country:US
Mailing Address - Phone:410-466-8558
Mailing Address - Fax:410-466-8550
Practice Address - Street 1:3927 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5634
Practice Address - Country:US
Practice Address - Phone:410-466-8558
Practice Address - Fax:410-466-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility