Provider Demographics
NPI:1720273337
Name:HOUSE OF NEW BEGINNING OF DUPLIN
Entity Type:Organization
Organization Name:HOUSE OF NEW BEGINNING OF DUPLIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BENNERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-285-8305
Mailing Address - Street 1:808 MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:WALLACE
Mailing Address - State:NC
Mailing Address - Zip Code:28466-2530
Mailing Address - Country:US
Mailing Address - Phone:910-285-8305
Mailing Address - Fax:910-285-8305
Practice Address - Street 1:808 MIAMI AVE
Practice Address - Street 2:
Practice Address - City:WALLACE
Practice Address - State:NC
Practice Address - Zip Code:28466-2530
Practice Address - Country:US
Practice Address - Phone:910-285-8305
Practice Address - Fax:910-285-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness