Provider Demographics
NPI:1740411958
Name:A NEW START SUPPORT SERVICES II, LLC
Entity Type:Organization
Organization Name:A NEW START SUPPORT SERVICES II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLINDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:RODRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:919-359-0669
Mailing Address - Street 1:11373 US BUSINESS 70 HWY WEST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2208
Mailing Address - Country:US
Mailing Address - Phone:919-359-0669
Mailing Address - Fax:919-359-2171
Practice Address - Street 1:11373 US BUSINESS 70 HWY WEST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2208
Practice Address - Country:US
Practice Address - Phone:919-359-0669
Practice Address - Fax:919-359-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC989101YA0400X
NC2010-012412084P0800X
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty