Provider Demographics
NPI:1184760589
Name:NEW START OF NORTH CAROLINA
Entity type:Organization
Organization Name:NEW START OF NORTH CAROLINA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-756-0566
Mailing Address - Street 1:708 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3083
Mailing Address - Country:US
Mailing Address - Phone:252-413-0064
Mailing Address - Fax:252-756-5796
Practice Address - Street 1:708 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3083
Practice Address - Country:US
Practice Address - Phone:252-413-0064
Practice Address - Fax:252-756-5796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7803798Medicaid
NC8300901Medicaid