Provider Demographics
NPI:1306242821
Name:NEW DIRECTIONS HEALTHCARE LLC
Entity type:Organization
Organization Name:NEW DIRECTIONS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:814-240-6216
Mailing Address - Street 1:306 W 11TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1746
Mailing Address - Country:US
Mailing Address - Phone:814-240-6216
Mailing Address - Fax:814-240-6219
Practice Address - Street 1:306 W 11TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1746
Practice Address - Country:US
Practice Address - Phone:814-240-6216
Practice Address - Fax:814-240-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-11
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA257084261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone