Nuevo Destino Health Alliance LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

2008-01590 Issued in NC

Legal business name

NUEVO DESTINO HEALTH ALLIANCE LLC

Practice address

1244 N Flint St
Lincolnton, NC 28092-5239

Phone

(704) 732-0513

NPI assigned

Jul 12, 2011

Organization subpart

No

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

Authorized official

Name

Karen L Melendez, M.D.

Title

Owner

Phone

(704) 732-0513

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1578851580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 N FLINT ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280925239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N FLINT ST",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "280925239",
            "telephone_number": "704-732-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUEVO DESTINO HEALTH ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "MELENDEZ",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-732-0513",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NC",
            "license": "2008-01590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Lincolnton, NC
• Providers in Lincolnton, NC by specialty
• Adolescent and Children Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.