Provider Demographics
NPI:1831762319
Name:NEW HOPE BEHAVIORAL HEALTH RESIDENTIAL
Entity type:Organization
Organization Name:NEW HOPE BEHAVIORAL HEALTH RESIDENTIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GAHAKANYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-413-0143
Mailing Address - Street 1:9624 W TRUMBULL RD
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-5729
Mailing Address - Country:US
Mailing Address - Phone:480-466-3452
Mailing Address - Fax:
Practice Address - Street 1:9624 W TRUMBULL RD
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-5729
Practice Address - Country:US
Practice Address - Phone:480-466-3452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD01239056Medicaid