Provider Demographics
NPI:1225490535
Name:A NEW DAY COMMUNITY HEALTH CENTER INC
Entity Type:Organization
Organization Name:A NEW DAY COMMUNITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHIFODUNRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-934-3936
Mailing Address - Street 1:3085 E. FLAMINGO ROAD SUITE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3085 E FLAMINGO RD STE A
Practice Address - Street 2:STREET IS REQUIRED
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4385
Practice Address - Country:US
Practice Address - Phone:404-934-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVE0057402016-7208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV20161075955Medicaid
NVNV20161075955Medicaid