Provider Demographics
NPI:1720313778
Name:NEW LEAF BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:NEW LEAF BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-781-8370
Mailing Address - Street 1:3725 NATIONAL DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4879
Mailing Address - Country:US
Mailing Address - Phone:919-781-8370
Mailing Address - Fax:
Practice Address - Street 1:3725 NATIONAL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4879
Practice Address - Country:US
Practice Address - Phone:919-781-8370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty