Provider Demographics
NPI:1740825942
Name:NEWHOPE CLINIC CORP
Entity type:Organization
Organization Name:NEWHOPE CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MNGR
Authorized Official - Prefix:
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:IBANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-586-2088
Mailing Address - Street 1:1212 NW 79TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-8209
Mailing Address - Country:US
Mailing Address - Phone:786-273-0209
Mailing Address - Fax:
Practice Address - Street 1:1212 NW 79TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-8209
Practice Address - Country:US
Practice Address - Phone:786-273-0209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health