MEDICARE: NEW PLACE, INC.

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	MHL-060-648	NC
2	320800000X	Mental Illness Community Based Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780803858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW PLACE, INC.

Provider Business Mailing Address
First Line	:	6612 E WT HARRIS BLVD
Second Line	:	SUITE D
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-5134
Country	:	US
Telephone Number	:	704-567-8984
Fax Number	:	704-567-8954

Provider Business Practice Location Address
First Line	:	9709 BATTEN CT
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-4137
Country	:	US
Telephone Number	:	704-567-8984
Fax Number	:	704-271-9718

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JAMES ARNELL HUNT
Credential	:
Telephone Number	:	704-567-8984

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	09/06/2019

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Directions to “NEW PLACE, INC. ” Practice Location

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