Provider Demographics
NPI:1457798795
Name:NEW JOURNEY FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:NEW JOURNEY FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMESHULAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PROCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-435-0989
Mailing Address - Street 1:156A BAKER ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-1720
Mailing Address - Country:US
Mailing Address - Phone:434-634-3060
Mailing Address - Fax:703-543-0564
Practice Address - Street 1:156A BAKER ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1720
Practice Address - Country:US
Practice Address - Phone:434-634-3060
Practice Address - Fax:703-543-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health