Provider Demographics
NPI:1891167169
Name:NEW HOPE THERAPY, LLC
Entity Type:Organization
Organization Name:NEW HOPE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:270-442-6399
Mailing Address - Street 1:3227 COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-6563
Mailing Address - Country:US
Mailing Address - Phone:270-442-6399
Mailing Address - Fax:270-442-6300
Practice Address - Street 1:3227 COLEMAN RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-6563
Practice Address - Country:US
Practice Address - Phone:270-442-6399
Practice Address - Fax:270-442-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYSLPLPA00193918235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100327880Medicaid
1114347176OtherINDIVIDUAL NPI