Healthcare Provider Details

I. General information

NPI: 1588025902
Provider Name (Legal Business Name): A NEW DAY COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2016
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5949 W NORTHERN AVE STE 105
GLENDALE AZ
85301-7800
US

IV. Provider business mailing address

3670 N RANCHO DR
LAS VEGAS NV
89130-3174
US

V. Phone/Fax

Practice location:
  • Phone: 404-454-9721
  • Fax:
Mailing address:
  • Phone: 404-454-9721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: FRAN OSHIFODUNRIN
Title or Position: CEO
Credential:
Phone: 404-454-9721