NPIMap

Organization Active NPI

New Outlook Second Chance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Durham, NC
National Provider Identifier
1104069905
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
NEW OUTLOOK SECOND CHANCE, INC.
Practice address
331 W Main St
Suite 302-306
Durham, NC 27701-3232
Phone
(919) 682-4771
Fax
(919) 683-2641
NPI assigned
Apr 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
Ms. Bethena M Jackson
Title
Executive Director
Phone
(919) 682-4771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

331 W Main St
Suite 302-306
Durham, NC 27701-3232

Mailing address

331 W Main St
Suite 302-306
Durham, NC 27701-3232
Phone (919) 682-4771

Other identifiers 2

IdentifierTypeStateIssuer
8302362BMedicaidNC
8302362GMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
New Outlook Second Chance Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1104069905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 W MAIN ST",
            "address_2": "SUITE 302-306",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013232",
            "telephone_number": "919-682-4771",
            "fax_number": "919-683-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W MAIN ST",
            "address_2": "SUITE 302-306",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013232",
            "telephone_number": "919-682-4771",
            "fax_number": "919-683-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW OUTLOOK SECOND CHANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BETHENA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-682-4771",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302362B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302362G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.