Provider Demographics
NPI:1669517272
Name:NEW DIRECTIONS HOME HEALTH
Entity type:Organization
Organization Name:NEW DIRECTIONS HOME HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MA ED
Authorized Official - Phone:910-640-3711
Mailing Address - Street 1:110 PREMIERE PLZ
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-2522
Mailing Address - Country:US
Mailing Address - Phone:910-640-3711
Mailing Address - Fax:910-640-3760
Practice Address - Street 1:110 PREMIERE PLZ
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-2522
Practice Address - Country:US
Practice Address - Phone:910-640-3711
Practice Address - Fax:910-640-3760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005796Medicaid