Provider Demographics
NPI:1962703777
Name:NEW DIRECTION MINISTRIES, INCORPORATED
Entity type:Organization
Organization Name:NEW DIRECTION MINISTRIES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUETTA
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:BULLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, HIA
Authorized Official - Phone:252-430-1681
Mailing Address - Street 1:PO BOX 2581
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-6581
Mailing Address - Country:US
Mailing Address - Phone:252-430-1680
Mailing Address - Fax:252-430-1681
Practice Address - Street 1:825 THOMAS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27537-8970
Practice Address - Country:US
Practice Address - Phone:252-430-3742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty