Provider Demographics
NPI:1962892281
Name:NEW HOPE MINISTRIES HOME HEALTH SERVICCES
Entity type:Organization
Organization Name:NEW HOPE MINISTRIES HOME HEALTH SERVICCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLLA
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:WATSON-MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:803-926-5279
Mailing Address - Street 1:130 BIG SHOT LN
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:SC
Mailing Address - Zip Code:29053-8216
Mailing Address - Country:US
Mailing Address - Phone:803-926-5279
Mailing Address - Fax:
Practice Address - Street 1:130 BIG SHOT LN
Practice Address - Street 2:
Practice Address - City:GASTON
Practice Address - State:SC
Practice Address - Zip Code:29053-8216
Practice Address - Country:US
Practice Address - Phone:803-926-5279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEA1699Medicaid