Provider Demographics
NPI:1932817053
Name:NEW HOPE SUPPORT SERVICES
Entity Type:Organization
Organization Name:NEW HOPE SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROGERS
Authorized Official - Middle Name:WEGNER
Authorized Official - Last Name:BUTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-668-5890
Mailing Address - Street 1:1941 HOME PATH CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-6971
Mailing Address - Country:US
Mailing Address - Phone:937-668-5890
Mailing Address - Fax:
Practice Address - Street 1:1941 HOME PATH CT
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-6971
Practice Address - Country:US
Practice Address - Phone:937-668-5890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services