1629522230 NPI number — NEW GENERATION RESOURCES

Table of content: (NPI 1629522230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629522230 NPI number — NEW GENERATION RESOURCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW GENERATION RESOURCES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GENERATIONS COUNSELING AND BEHAVIORAL SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629522230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 FAIRMONT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHLANDS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24641-3619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-202-4463
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
716 SPRING AVE SE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
WISE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24293-5702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-328-0022
Provider Business Practice Location Address Fax Number:
276-328-0032
Provider Enumeration Date:
08/11/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ELKINS
Authorized Official First Name:
CONNIE
Authorized Official Middle Name:
DENISE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
276-202-4463

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  0701006262 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com