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General NPI Number Information
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NPI Number | 1992076947
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Entity Type | Organization
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Legal Business Name | NEW WAY CARE HOME INC
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 1262 KING RD
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City | RIVERDALE
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State | GA
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Zip | 30296-2952
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Country | US
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Telephone | 770-573-4788
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Fax |
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Provider Business Mailing Address
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Address Line | 7142 BLACKJACK CT
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City | RIVERDALE
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State | GA
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Zip | 30296-2168
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Country | US
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Telephone | 770-629-5883
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHIRLEY VICTORIA NEWTON
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Credential |
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Telephone | 678-559-4025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State | GA
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