Provider Demographics
NPI:1679785182
Name:NEW HOPE CENTER, INC.
Entity type:Organization
Organization Name:NEW HOPE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:920-849-9351
Mailing Address - Street 1:443 MANHATTAN STREET
Mailing Address - Street 2:P.O. BOX 189
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1565
Mailing Address - Country:US
Mailing Address - Phone:920-849-9351
Mailing Address - Fax:
Practice Address - Street 1:105 WEST RAILROAD AVE.
Practice Address - Street 2:
Practice Address - City:ST. CLOUD
Practice Address - State:WI
Practice Address - Zip Code:53079
Practice Address - Country:US
Practice Address - Phone:920-999-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3173-026251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40808400Medicare ID - Type Unspecified