Provider Demographics
NPI:1225807316
Name:A NEW CREATION
Entity Type:Organization
Organization Name:A NEW CREATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:LADAWN
Authorized Official - Last Name:HOFFART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-350-2362
Mailing Address - Street 1:1115 2ND ST NE
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-3227
Mailing Address - Country:US
Mailing Address - Phone:701-350-2362
Mailing Address - Fax:
Practice Address - Street 1:1115 2ND ST NE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-3227
Practice Address - Country:US
Practice Address - Phone:701-350-2362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health