NEW WATERS RECOVERY NORTH CAROLINA LLC NPI 1407513534

NPI Information

NPI: 1407513534
Provider Name: NEW WATERS RECOVERY NORTH CAROLINA LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 34D2252372

Address:
3810 BLAND RD
RALEIGH, NC
ZIP 27609
Phone: (561) 632-0120
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NEW WATERS RECOVERY NORTH CAROLINA LLC is a rehabilitation and substance use disorder clinic center in Raleigh, NC. NEW WATERS RECOVERY NORTH CAROLINA LLC NPI is 1407513534. The provider is registered as an organization entity type.

The provider's business location address is:

3810 BLAND RD
RALEIGH, NC
ZIP 27609-239
Phone: (561) 632-0120

The provider's authorized official is Justin Mclendon .
The authorized official title is Executive Director and has the following contact phone number (561) 632-0120.

The CLIA number assigned to this NPI record is 34D2252372 - other - behavioral health detox with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2021 and was last updated on 11/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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