Provider Demographics
NPI:1003069683
Name:NEW DIMENSIONS INTERVENTIONS, INC
Entity Type:Organization
Organization Name:NEW DIMENSIONS INTERVENTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KAHNZA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-452-2754
Mailing Address - Street 1:111 TRAIL ONE STE 105
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5672
Mailing Address - Country:US
Mailing Address - Phone:919-452-2754
Mailing Address - Fax:
Practice Address - Street 1:2480 MICHELLE DR
Practice Address - Street 2:
Practice Address - City:GREEN LEVEL
Practice Address - State:NC
Practice Address - Zip Code:27217-8130
Practice Address - Country:US
Practice Address - Phone:919-452-2754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-001-165320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness