NPIMap

Organization Active NPI

New Lite Living Choices

  • Community/Behavioral Health Agency
  • Concord, NC
National Provider Identifier
1255507992
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NEW LITE LIVING CHOICES
Practice address
349 Copperfield Blvd NE
Suite 5
Concord, NC 28025-2408
Phone
(704) 771-0456
NPI assigned
May 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Tracy Gibbs
Title
Administrator
Phone
(704) 771-0456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

349 Copperfield Blvd NE
Suite 5
Concord, NC 28025-2408

Mailing address

PO Box 1310
Suite 5
Concord, NC 28026-1310
Phone (704) 771-0456

Other identifiers 1

IdentifierTypeStateIssuer
8300407MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Goldenblush Circle Group Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

349 Copperfield Blvd NE
Ste 5
Concord, NC 28025
Phone (704) 771-0456

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1255507992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1310",
            "address_2": "SUITE 5",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280261310",
            "telephone_number": "704-771-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 COPPERFIELD BLVD NE",
            "address_2": "SUITE 5",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252408",
            "telephone_number": "704-771-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LITE LIVING CHOICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-771-0456"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300407",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.