1033201223 NPI number — NEW DIRECTIONS HOME HEALTH CARE, INC.

Table of content: (NPI 1033201223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033201223 NPI number — NEW DIRECTIONS HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW DIRECTIONS HOME HEALTH CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEW DIRECTIONS COMMUNITY SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033201223
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/17/2007
NPI Reactivation Date:
09/18/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 2329
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28472-9145
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-640-3711
Provider Business Mailing Address Fax Number:
910-640-3760

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 PREMIERE PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28472-9145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-640-3711
Provider Business Practice Location Address Fax Number:
910-640-3760
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HERRING
Authorized Official First Name:
HEIDI
Authorized Official Middle Name:
Y.
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
910-640-3711

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251C00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: H2120 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: MHL-024-067 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6102127 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6111835 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300296 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301439 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6005796 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3409387 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600803 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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