Provider Demographics
NPI:1053049353
Name:A NEW JOURNEY LLC
Entity type:Organization
Organization Name:A NEW JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-809-0852
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27528-0094
Mailing Address - Country:US
Mailing Address - Phone:919-809-0852
Mailing Address - Fax:844-246-5039
Practice Address - Street 1:312 KILGO ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-1651
Practice Address - Country:US
Practice Address - Phone:919-809-0852
Practice Address - Fax:844-246-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-13
Last Update Date:2022-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle