Provider Demographics
NPI:1659689008
Name:ANEW FOCUS INC.
Entity Type:Organization
Organization Name:ANEW FOCUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-702-1633
Mailing Address - Street 1:PO BOX 375
Mailing Address - Street 2:
Mailing Address - City:SIMPSON
Mailing Address - State:NC
Mailing Address - Zip Code:27879-0375
Mailing Address - Country:US
Mailing Address - Phone:252-702-1633
Mailing Address - Fax:
Practice Address - Street 1:400 HOUSE RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:NC
Practice Address - Zip Code:27812-9527
Practice Address - Country:US
Practice Address - Phone:252-825-9563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-074-224320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness