Healthcare Provider Details

I. General information

NPI: 1699091348
Provider Name (Legal Business Name): NEW DAY YOUTH AND FAMILY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 EASY STREET CT
EDMOND OK
73012-4527
US

IV. Provider business mailing address

112 EASY STREET CT
EDMOND OK
73012-4527
US

V. Phone/Fax

Practice location:
  • Phone: 405-359-9013
  • Fax:
Mailing address:
  • Phone: 405-359-9013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number21902
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number21902
License Number StateOK

VIII. Authorized Official

Name: MRS. ROSELINE NSIKA
Title or Position: LPC CANDIDATE
Credential:
Phone: 405-525-0452