Provider Demographics
NPI:1447547484
Name:NEW HOPE YOUTH & FAMILY SERVICES
Entity type:Organization
Organization Name:NEW HOPE YOUTH & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OCTAVIA
Authorized Official - Middle Name:DEVONNE
Authorized Official - Last Name:SHANKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-361-5395
Mailing Address - Street 1:5736 N TRYON ST STE 130
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-6898
Mailing Address - Country:US
Mailing Address - Phone:704-361-5395
Mailing Address - Fax:980-207-3956
Practice Address - Street 1:5736 N TRYON ST STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-6898
Practice Address - Country:US
Practice Address - Phone:704-361-5395
Practice Address - Fax:980-207-3956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health