Provider Demographics
NPI:1013705789
Name:NEW PHASE SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:NEW PHASE SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, BSC, QMHP-CS
Authorized Official - Phone:985-688-7512
Mailing Address - Street 1:17836 PARNASSUM PATH
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-1426
Mailing Address - Country:US
Mailing Address - Phone:985-688-7512
Mailing Address - Fax:
Practice Address - Street 1:17836 PARNASSUM PATH
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302-1426
Practice Address - Country:US
Practice Address - Phone:985-688-7512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health