New Image

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

5354758 Issued in NC

Legal business name

NEW IMAGE

Practice address

408 Shepard St
Elizabeth City, NC 27909-5260

Phone

(252) 267-2833

NPI assigned

Aug 9, 2012

Organization subpart

No

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

Authorized official

Name

Craig Powell

Title

C.E.O

Phone

(252) 267-2833

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1528315595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 SHEPARD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279095260",
            "telephone_number": "252-267-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SHEPARD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279095260",
            "telephone_number": "252-267-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW IMAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "252-267-2833"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "5354758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Mental Illness 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 Aug 9, 2012; 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.