Provider Demographics
NPI:1861042715
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:MEDICAL BILL
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-737-9555
Mailing Address - Street 1:NEW HOPE COMMUNITY SERVICE CENTER
Mailing Address - Street 2:2559 WEST 79TH
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652
Mailing Address - Country:US
Mailing Address - Phone:773-737-9555
Mailing Address - Fax:
Practice Address - Street 1:NEW HOPE COMMUNITY SERVICE CENTER
Practice Address - Street 2:2559 WEST 79TH
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652
Practice Address - Country:US
Practice Address - Phone:773-737-9555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)