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General NPI Number Information
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NPI Number | 1568634053
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Entity Type | Organization
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Legal Business Name | A NEW VISION OF ALAMANCE,LLC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 103 JEFFERSON ST
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City | BURLINGTON
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State | NC
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Zip | 27217-1338
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Country | US
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Telephone | 336-222-7001
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2661
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City | BURLINGTON
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State | NC
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Zip | 27216-2661
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Country | US
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Telephone | 336-222-7001
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. LUCY CAROL HAGGAN
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Credential |
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Telephone | 336-222-7001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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