Provider Demographics
NPI:1760864771
Name:NEW WAY FOUNDATION YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:NEW WAY FOUNDATION YOUTH AND FAMILY SERVICES
Other - Org Name:NWF YOUTH AND FAMILY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:GENESIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:NEWSOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-497-3862
Mailing Address - Street 1:1001 E WT HARRIS BLVD
Mailing Address - Street 2:STE P 150
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 E WT HARRIS BLVD
Practice Address - Street 2:STE P 150
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4104
Practice Address - Country:US
Practice Address - Phone:704-497-3862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health