Provider Demographics
NPI:1326639931
Name:NEW JOURNEY HOME & HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:NEW JOURNEY HOME & HEALTH CARE SERVICES LLC
Other - Org Name:NEW JOURNEY HOME HEALTH CARE SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-289-4071
Mailing Address - Street 1:529 GRAYSON LN
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-3084
Mailing Address - Country:US
Mailing Address - Phone:254-289-4071
Mailing Address - Fax:
Practice Address - Street 1:529 GRAYSON LN
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-3084
Practice Address - Country:US
Practice Address - Phone:254-289-4071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1174023063Medicaid