Provider Demographics
NPI:1982981882
Name:NEW TRANSITION LLC
Entity Type:Organization
Organization Name:NEW TRANSITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:704-913-2515
Mailing Address - Street 1:1589 ROLLING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-6325
Mailing Address - Country:US
Mailing Address - Phone:704-913-2515
Mailing Address - Fax:
Practice Address - Street 1:1589 ROLLING MEADOW LN
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-6325
Practice Address - Country:US
Practice Address - Phone:704-913-2515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children