Provider Demographics
NPI:1679614309
Name:NEW RAY OF HOPE, INC.
Entity type:Organization
Organization Name:NEW RAY OF HOPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRPPKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-793-8449
Mailing Address - Street 1:1305 HENDREN CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-4937
Mailing Address - Country:US
Mailing Address - Phone:678-793-8449
Mailing Address - Fax:770-465-2374
Practice Address - Street 1:588 KINGSGATE RDG
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-1828
Practice Address - Country:US
Practice Address - Phone:678-793-8449
Practice Address - Fax:770-465-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL092533320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603563Medicaid