Provider Demographics
NPI:1730550047
Name:NEW JOURNEY RESIDENCE, LTD
Entity type:Organization
Organization Name:NEW JOURNEY RESIDENCE, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-360-5595
Mailing Address - Street 1:303 HAT TRICK AVE
Mailing Address - Street 2:
Mailing Address - City:EVELETH
Mailing Address - State:MN
Mailing Address - Zip Code:55734-8635
Mailing Address - Country:US
Mailing Address - Phone:218-744-5907
Mailing Address - Fax:218-744-2490
Practice Address - Street 1:303 HAT TRICK AVE
Practice Address - Street 2:
Practice Address - City:EVELETH
Practice Address - State:MN
Practice Address - Zip Code:55734-8635
Practice Address - Country:US
Practice Address - Phone:218-744-5907
Practice Address - Fax:218-744-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility