1790870806 NPI number — A NEW DAY COUNSELING CENTER, INC.

Table of content: (NPI 1790870806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790870806 NPI number — A NEW DAY COUNSELING CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A NEW DAY COUNSELING CENTER, INC.
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:
1790870806
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3915 N AVE
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
KEARNEY
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68847-2699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-236-9105
Provider Business Mailing Address Fax Number:
308-236-9903

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3915 N AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
KEARNEY
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68847-2699
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-236-9105
Provider Business Practice Location Address Fax Number:
308-236-9903
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORAN
Authorized Official First Name:
TERRI
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
BUSINESS PARTNER
Authorized Official Telephone Number:
308-236-9105

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 732316000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10025789800 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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