Provider Demographics
NPI:1215193412
Name:A BRAND NEW DAY
Entity Type:Organization
Organization Name:A BRAND NEW DAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRISTY
Authorized Official - Middle Name:SHERYLL
Authorized Official - Last Name:KINCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-248-6751
Mailing Address - Street 1:213 W BLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1003
Mailing Address - Country:US
Mailing Address - Phone:859-248-6751
Mailing Address - Fax:
Practice Address - Street 1:213 W BLAIR AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1003
Practice Address - Country:US
Practice Address - Phone:859-248-6751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYPENDINGMedicaid