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General NPI Number Information
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NPI Number | 1013705789
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Entity Type | Organization
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Legal Business Name | NEW PHASE SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 17836 PARNASSUM PATH
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City | CONROE
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State | TX
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Zip | 77302-1426
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Country | US
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Telephone | 985-688-7512
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Fax |
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Provider Business Mailing Address
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Address Line | 17836 PARNASSUM PATH
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City | CONROE
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State | TX
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Zip | 77302-1426
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Country | US
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Telephone | 985-688-7512
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Fax |
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | GINGER C RUFFIN
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Credential | MSC, BSC, QMHP-CS
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Telephone | 985-688-7512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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