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General NPI Number Information
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NPI Number | 1518418748
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Entity Type | Organization
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Legal Business Name | NEW LIFE TRANSITIONS 2
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 103 WESTWOOD DR
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City | GREENVILLE
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State | NC
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Zip | 27834
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Country | US
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Telephone | 252-412-3296
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Fax |
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Provider Business Mailing Address
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Address Line | 3919 STERLING POINTE DRIVE UNIT NN8
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City | WINTERVILLE
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State | NC
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Zip | 28590
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Country | US
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Telephone | 252-412-3296
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NICOLE LEA TRENT WATERS
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Credential | AAS
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Telephone | 252-412-3296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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