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General NPI Number Information
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NPI Number | 1033545280
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Entity Type | Organization
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Legal Business Name | 8 NEW BEGINNING WITH KAYANDA, INC
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 1919-A BOULEVARD STREET
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City | GREENSBORO
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State | NC
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Zip | 27407
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Country | US
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Telephone | 336-295-1830
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Fax | 336-459-3713
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Provider Business Mailing Address
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Address Line | 1919-A BOULEVARD STREET
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City | GREENSBORO
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State | NC
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Zip | 27407
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Country | US
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Telephone | 336-295-1830
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Fax | 336-459-3713
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Authorized Official
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Title or Position | CEO
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Name | DR. OCTAVE KAYANDA
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Credential |
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Telephone | 33650021741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL0411058
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License Number State | NC
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