New Waters Recovery North Carolina LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

NEW WATERS RECOVERY NORTH CAROLINA LLC

Practice address

3810 Bland Rd
Raleigh, NC 27609-6239

Phone

(561) 632-0120

NPI assigned

Nov 23, 2021

Organization subpart

No

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

Authorized official

Name

Justin McLendon, LCAS, LCMHCNPI 1114445889

Title

Executive Director

Phone

(561) 632-0120

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

New Waters Recovery North Carolina LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• New Waters Residential

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Raleigh, NC
  • NPI 1215887625
  NPD tax ID

Subparts reporting this organization as parent 1

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

• New Waters Residential

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Raleigh, NC
  • NPI 1215887625
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin McLendon, LCMHC, LCAS

  • Professional Counselor
  • Cary, NC
  • NPI 1114445889
  NPD Authorized official
• Harold Hong, MD

  • Psychiatry Physician
  • Durham, NC
  • NPI 1558537415
  NPD (past)

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1407513534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 BLAND RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096239",
            "telephone_number": "561-632-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 BLAND RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096239",
            "telephone_number": "561-632-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW WATERS RECOVERY NORTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "MCLENDON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "561-632-0120",
        "authorized_official_credential": "LCAS, LCMHC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Life Connection
• New Life Home Healthcare, Inc.
• New Path Recovery and Rehab
• New Perspective Wellness, Inc.
• New Vision Eyecare OD PA
• New Waters Residential
• Jeffrey New, PHARMD
• Tara Newbaker, PHARMD
• Newbeginnings 4 U Inc.
• Adam Newcomb, CNIM

• Substance Use Disorder Rehabilitation Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.