=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942834197
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW PERCEPTIONS NORTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2020
-----------------------------------------------------
Last Update Date | 01/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13565 GRANGEVILLE BLVD
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230-9465
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-670-3076
-----------------------------------------------------
Fax | 559-670-3094
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 240 N 12TH AVE SUITE 109 BOX 324
-----------------------------------------------------
City | HANFORD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-670-3076
-----------------------------------------------------
Fax | 559-670-3094
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROGRAM DIRECTOR
-----------------------------------------------------
Name | KRISTY HENINGER-DAY
-----------------------------------------------------
Credential | CADC-I
-----------------------------------------------------
Telephone | 559-978-7803
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0405X
-----------------------------------------------------
Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------