Healthcare Provider Details

I. General information

NPI: 1942863204
Provider Name (Legal Business Name): A NEW WELL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 COUNTRY CLUB DR
STOCKBRIDGE GA
30281-7350
US

IV. Provider business mailing address

325 COUNTRY CLUB DR
STOCKBRIDGE GA
30281-7350
US

V. Phone/Fax

Practice location:
  • Phone: 800-341-0120
  • Fax: 866-341-3403
Mailing address:
  • Phone: 800-341-0120
  • Fax: 866-341-3403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RHONDA A CROCKETT
Title or Position: CEO
Credential:
Phone: 800-341-0120