Basic Information
| Provider Information | |||||||||
| NPI: | 1851838817 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEW HOPE CHRISTIAN COUNSELING FOUNDATION, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 464 S PALM AVE STE C-D | ||||||||
| Address2: | |||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925434808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512476542 | ||||||||
| FaxNumber: | 9512476959 | ||||||||
| Practice Location | |||||||||
| Address1: | 464 S PALM AVE STE C-D | ||||||||
| Address2: | |||||||||
| City: | HEMET | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512476542 | ||||||||
| FaxNumber: | 9512476959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2017 | ||||||||
| LastUpdateDate: | 07/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | KAYES | ||||||||
| AuthorizedOfficialFirstName: | MAX | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9512476542 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NEW HOPE CHRISTIAN COUNSELING FOUNDATION, INC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | LMFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.