Provider Demographics
NPI:1629277397
Name:NEW START OF NORTH CAROLINA
Entity Type:Organization
Organization Name:NEW START OF NORTH CAROLINA
Other - Org Name:CHANDLER'S HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWENER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-327-8225
Mailing Address - Street 1:PO BOX 1523
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-1523
Mailing Address - Country:US
Mailing Address - Phone:252-413-0064
Mailing Address - Fax:252-439-0666
Practice Address - Street 1:708 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3083
Practice Address - Country:US
Practice Address - Phone:252-413-0064
Practice Address - Fax:252-439-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300901BMedicaidCOMMUNITY SUPPORT