Provider Demographics
NPI:1013331438
Name:NEW HOPE RESTORATIVE CARE, LLC
Entity Type:Organization
Organization Name:NEW HOPE RESTORATIVE CARE, LLC
Other - Org Name:THELMA WASHINGTON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-331-6340
Mailing Address - Street 1:8060 WEBB RD #741235
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-5502
Mailing Address - Country:US
Mailing Address - Phone:770-991-7788
Mailing Address - Fax:770-991-7727
Practice Address - Street 1:710 KING RD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2027
Practice Address - Country:US
Practice Address - Phone:770-991-7788
Practice Address - Fax:770-991-7727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW006347104100000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty