NPIMap

Organization Active NPI

New Destinations, Inc.

  • Community/Behavioral Health Agency
  • Statesville, NC
National Provider Identifier
1831429174
Registry record updated Aug 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-049-121 Issued in NC
Legal business name
NEW DESTINATIONS, INC.
Practice address
711 Brookdale Dr
Statesville, NC 28677-3405
Phone
(919) 414-2860
Fax
(704) 872-6766
NPI assigned
Jan 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-049-121 NC Primary
Adult Care Home Facility 311ZA0620X MHL-049-121 NC
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

711 Brookdale Dr
Statesville, NC 28677-3405

Mailing address

5720 Turner Store LN
Raleigh, NC 27603-7976
Phone (919) 414-2860

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": "1502841600000",
    "number": "1831429174",
    "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": "919-414-2860",
            "fax_number": "980-225-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773405",
            "telephone_number": "919-414-2860",
            "fax_number": "704-872-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DESTINATIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-09",
        "last_updated": "2017-08-16",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-049-121",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-049-121",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.