Provider Demographics
NPI:1376980334
Name:NEW CENTURY SUPPORT SERVICES
Entity Type:Organization
Organization Name:NEW CENTURY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORTS COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEYMERS
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW, C-SWCM, QMRP
Authorized Official - Phone:810-234-7080
Mailing Address - Street 1:5095 VAN SLYKE RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3959
Mailing Address - Country:US
Mailing Address - Phone:810-234-7080
Mailing Address - Fax:810-235-4999
Practice Address - Street 1:5095 VAN SLYKE RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3959
Practice Address - Country:US
Practice Address - Phone:810-234-7080
Practice Address - Fax:810-235-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802084608251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6802084608OtherMICHIGAN LICENSED BACHELORS SOCIAL WORKER