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
711 BROOKDALE DR, STATESVILLE, NC 28677-3405
(704) 380-2903
(704) 380-2903
Mailing address
PO BOX 287, RUTHERFORD COLLEGE, NC 28671-0287
(919) 773-2706
(980) 225-0385
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
NC
Other
Enumeration date
07/20/2012
Last updated
07/21/2013
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