MEDICARE: NEW DIRECTION TRANSITIONAL HOMES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578292405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW DIRECTION TRANSITIONAL HOMES

Provider Business Mailing Address
First Line	:	338 BURROUGHS AVE
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-2709
Country	:	US
Telephone Number	:	810-299-6893
Fax Number	:

Provider Business Practice Location Address
First Line	:	13854 LAKESIDE CIR # 510-O
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-1443
Country	:	US
Telephone Number	:	586-271-6989
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PORSHIA MONTGOMERY
Credential	:
Telephone Number	:	810-299-6893

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	06/07/2022

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