Organization Active NPI

New Destinations, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Goldsboro, NC
National Provider Identifier
1568792802
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
NEW DESTINATIONS, INC.
Practice address
404 S Claiborne St
Goldsboro, NC 27530-5310
Phone
(919) 736-0484
Fax
(919) 736-3408
NPI assigned
Jan 9, 2010
Last updated
Jul 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Authorized official

Name
Mr. Larry Lee Lackey
Title
Executive Director
Phone
(919) 414-2860

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X MHL-096-225 NC
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

404 S Claiborne St
Goldsboro, NC 27530-5310

Mailing address

5720 Turner Store LN
Raleigh, NC 27603-7976
Phone (828) 572-2024

National Provider Directory

National Provider Directory
Tax ID family
New Destinations Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1262995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499385600000",
    "number": "1568792802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 TURNER STORE LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276037976",
            "telephone_number": "828-572-2024",
            "fax_number": "980-225-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S CLAIBORNE ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275305310",
            "telephone_number": "919-736-0484",
            "fax_number": "919-736-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DESTINATIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-09",
        "last_updated": "2017-07-07",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-414-2860",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-096-225",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2017; 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.