Provider Demographics
NPI:1518418748
Name:NEW LIFE TRANSITIONS 2
Entity Type:Organization
Organization Name:NEW LIFE TRANSITIONS 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:TRENT WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:AAS
Authorized Official - Phone:252-412-3296
Mailing Address - Street 1:3919 STERLING POINTE DRIVE
Mailing Address - Street 2:UNIT NN8
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590
Mailing Address - Country:US
Mailing Address - Phone:252-412-3296
Mailing Address - Fax:
Practice Address - Street 1:103 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-412-3296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services