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Organization
NEW DESTINATIONS, INC.
Active
Organization
NEW DESTINATIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LEE LACKEY (DIRECTOR)
(919) 773-2706
Entity
Organization
Contact information
Practice address
213 BROAD ST, MOUNT AIRY, NC 27030-4685
(336) 786-9526
(336) 786-9736
Mailing address
5720 TURNER STORE LN, RALEIGH, NC 27603-7976
(919) 773-2706
(980) 225-0385
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NULL
3104A0625X
Assisted Living Facility (Mental Illness)
—
NULL
311ZA0620X
Adult Care Home Facility
—
NULL
Other
Enumeration date
07/30/2012
Last updated
07/01/2016
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