Provider Demographics
NPI:1356074058
Name:NEW HEIGHTS RESIDENCES LLC
Entity Type:Organization
Organization Name:NEW HEIGHTS RESIDENCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-631-3303
Mailing Address - Street 1:3902 CHATHAM RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-5867
Mailing Address - Country:US
Mailing Address - Phone:443-631-3303
Mailing Address - Fax:
Practice Address - Street 1:3902 CHATHAM RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-5867
Practice Address - Country:US
Practice Address - Phone:443-631-3303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness