Basic Information
| Provider Information | |||||||||
| NPI: | 1720347818 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW DIRECTIONS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30800 CHARGRIN BOULEVARD | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165910324 | ||||||||
| FaxNumber: | 2165911243 | ||||||||
| Practice Location | |||||||||
| Address1: | 30800 CHARGRIN BOULEVARD | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165910324 | ||||||||
| FaxNumber: | 2165911243 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2012 | ||||||||
| LastUpdateDate: | 05/09/2012 | ||||||||
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| AuthorizedOfficialLastName: | MATONEY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2165910324 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MBA,LICDC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3245S0500X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
ID Information
| ID | Type | State | Issuer | Description | 2877463 | 05 | OH | MEDICAID |