Provider Demographics
NPI:1578292405
Name:NEW DIRECTION TRANSITIONAL HOMES
Entity Type:Organization
Organization Name:NEW DIRECTION TRANSITIONAL HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PORSHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-299-6893
Mailing Address - Street 1:338 BURROUGHS AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2709
Mailing Address - Country:US
Mailing Address - Phone:810-299-6893
Mailing Address - Fax:
Practice Address - Street 1:13854 LAKESIDE CIR # 510-O
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1443
Practice Address - Country:US
Practice Address - Phone:586-271-6989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health