1326766585 NPI number — NEW DAY RISING

Table of content: (NPI 1326766585)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326766585 NPI number — NEW DAY RISING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW DAY RISING
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:
Provider Other Organization Name Type Code:
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:
1326766585
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3623 CROSSINGS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRESCOTT
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86305-7101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13690 S BURTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING VALLEY
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86333-4245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-988-9111
Provider Business Practice Location Address Fax Number:
855-988-9111
Provider Enumeration Date:
08/15/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
ERIN
Authorized Official Middle Name:
KATHLEEN
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
928-460-2684

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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