Provider Demographics
NPI:1932812419
Name:NEW HOPE BEHAVIORAL RESIDENTIAL LLC
Entity Type:Organization
Organization Name:NEW HOPE BEHAVIORAL RESIDENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:REMY
Authorized Official - Last Name:NAHIMANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-545-6580
Mailing Address - Street 1:12514 W WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-6020
Mailing Address - Country:US
Mailing Address - Phone:623-600-8683
Mailing Address - Fax:623-600-8683
Practice Address - Street 1:12514 W WILLOW AVE
Practice Address - Street 2:
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-6020
Practice Address - Country:US
Practice Address - Phone:623-600-8683
Practice Address - Fax:623-600-8683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness