Healthcare Provider Details

I. General information

NPI: 1740720036
Provider Name (Legal Business Name): NEW PLACE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 04/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5419 TWIN LN
CHARLOTTE NC
28269-4635
US

IV. Provider business mailing address

6612 E WT HARRIS BLVD
CHARLOTTE NC
28215-5134
US

V. Phone/Fax

Practice location:
  • Phone: 704-804-9075
  • Fax: 704-567-8953
Mailing address:
  • Phone: 704-567-8953
  • Fax: 704-567-8953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. HAWA E HUNT
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 704-567-8953