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NPI 1578292405

NPI 1578292405 : NEW DIRECTION TRANSITIONAL HOMES : STERLING HEIGHTS, MI

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General NPI Number Information
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    NPI Number           |    1578292405
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    Entity Type          |    Organization 
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    Legal Business Name  |    NEW DIRECTION TRANSITIONAL HOMES 
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Dates
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    Enumeration Date     |    06/07/2022
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    Last Update Date     |    06/07/2022
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Provider Practice Location Address
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    Address Line         |    13854 LAKESIDE CIR # 510-O 
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    City                 |    STERLING HEIGHTS
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    State                |    MI
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    Zip                  |    48313-1443
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    Country              |    US
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    Telephone            |    586-271-6989
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    338 BURROUGHS AVE 
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    City                 |    FLINT
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    State                |    MI
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    Zip                  |    48507-2709
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    Country              |    US
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    Telephone            |    810-299-6893
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     PORSHIA  MONTGOMERY 
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    Credential           |    
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    Telephone            |    810-299-6893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    
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