Healthcare Provider Details

I. General information

NPI: 1346555349
Provider Name (Legal Business Name): NEW DIRECTION MINISTRIES, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 THOMAS ROAD
HENDERSON NC
27537
US

IV. Provider business mailing address

POST OFFICE BOX 2581
HENDERSON NC
27536
US

V. Phone/Fax

Practice location:
  • Phone: 252-204-6616
  • Fax:
Mailing address:
  • Phone: 252-430-1680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. JACQUETTA HARRISON BULLOCK
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA, HIAA
Phone: 252-430-1681