Healthcare Provider Details

I. General information

NPI: 1225075674
Provider Name (Legal Business Name): NEW DIRECTIONS GROUP CARE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 MEMORY PLZ
WHITEVILLE NC
28472-2640
US

IV. Provider business mailing address

116 MEMORY PLZ PO BOX 1442
WHITEVILLE NC
28472-2640
US

V. Phone/Fax

Practice location:
  • Phone: 910-640-1737
  • Fax: 910-640-1703
Mailing address:
  • Phone: 910-640-1737
  • Fax: 910-640-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC2950
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number3408208
License Number StateNC

VIII. Authorized Official

Name: MELODY JERNIGAN SPIVEY
Title or Position: BUSINESS MGR./ CO OWNER
Credential:
Phone: 910-640-1737