New Life Residential, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

NEW LIFE RESIDENTIAL, INC

Practice address

119 Hilltop Dr
Four Oaks, NC 27524-9686

Phone

(919) 628-3339

Fax

(919) 209-9703

NPI assigned

Jun 2, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Holly Grey

Title

Residential Director

Phone

(919) 710-0581

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1013201599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 HILLTOP DR",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275249686",
            "telephone_number": "919-628-3339",
            "fax_number": "919-209-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 HILLTOP DR",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275249686",
            "telephone_number": "919-628-3339",
            "fax_number": "919-209-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE RESIDENTIAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "GREY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "RESIDENTIAL DIRECTOR",
        "authorized_official_telephone_number": "919-710-0581"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-051-193",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Four Oaks, NC
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.