Provider Demographics
NPI:1558580639
Name:NEW PLACE, INC.
Entity Type:Organization
Organization Name:NEW PLACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ARNELL
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-567-8984
Mailing Address - Street 1:6612 E WT HARRIS BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-5134
Mailing Address - Country:US
Mailing Address - Phone:704-567-8984
Mailing Address - Fax:704-567-8954
Practice Address - Street 1:5601 FAULCONBRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-2518
Practice Address - Country:US
Practice Address - Phone:704-567-8984
Practice Address - Fax:704-567-8954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320800000X
NCMHL-060-776322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603151Medicaid