Provider Demographics
NPI:1205161346
Name:NEW HOPE MANOR, INC.
Entity type:Organization
Organization Name:NEW HOPE MANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARRI
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:845-557-8353
Mailing Address - Street 1:35 HILLSIDE RD
Mailing Address - Street 2:
Mailing Address - City:BARRYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12719-5561
Mailing Address - Country:US
Mailing Address - Phone:845-557-8353
Mailing Address - Fax:845-557-6603
Practice Address - Street 1:35 HILLSIDE RD
Practice Address - Street 2:
Practice Address - City:BARRYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12719-5561
Practice Address - Country:US
Practice Address - Phone:845-557-8353
Practice Address - Fax:845-557-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100210063324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility