Provider Demographics
NPI:1073875514
Name:NEW DAWN
Entity Type:Organization
Organization Name:NEW DAWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:COUNSELOR
Authorized Official - Phone:775-343-9951
Mailing Address - Street 1:2121 FORT BRIDGER RD
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-7104
Mailing Address - Country:US
Mailing Address - Phone:775-343-9951
Mailing Address - Fax:775-575-6593
Practice Address - Street 1:2121 FORT BRIDGER RD
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-7104
Practice Address - Country:US
Practice Address - Phone:775-343-9951
Practice Address - Fax:775-575-6593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20111730720251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health