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General NPI Number Information
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NPI Number | 1437480910
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Entity Type | Organization
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Legal Business Name | A NEW DAY
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 1424 DEBORAH RD SE SUITE 205
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City | RIO RANCHO
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State | NM
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Zip | 87124-1058
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Country | US
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Telephone | 505-892-4646
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Fax | 505-892-4775
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Provider Business Mailing Address
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Address Line | 1424 DEBORAH RD. SE STE 205
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City | RIO RANCHO
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State | NM
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Zip | 87124
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Country | US
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Telephone | 505-892-4646
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Fax | 505-892-4775
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | CAROL WHITE
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Credential | LISW
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Telephone | 505-860-6060
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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 | I-07119
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License Number State | NM
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