Provider Demographics
NPI:1821118456
Name:JAMES N. HARDWICK
Entity Type:Organization
Organization Name:JAMES N. HARDWICK
Other - Org Name:NEW LEAF COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:NOLAN
Authorized Official - Last Name:HARDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-791-9048
Mailing Address - Street 1:4673 THORNTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5663
Mailing Address - Country:US
Mailing Address - Phone:510-791-8006
Mailing Address - Fax:510-791-0939
Practice Address - Street 1:1254 HIGH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5015
Practice Address - Country:US
Practice Address - Phone:530-889-9195
Practice Address - Fax:530-889-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310007AP251S00000X
CA310007BP324500000X
CA310007CP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3126Medicare ID - Type UnspecifiedHIGH OUTPATIENT PROVIDER
CA3111Medicare ID - Type UnspecifiedMEADOWVIEW RESIDENTIAL
CA3105Medicare ID - Type UnspecifiedHOFFMAN RESIDENTIAL