Provider Demographics
NPI:1235455932
Name:NEW HEALTH PROGRAMS ASSOCIATION
Entity Type:Organization
Organization Name:NEW HEALTH PROGRAMS ASSOCIATION
Other - Org Name:NEW HEALTH LAKE SPOKANE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:POE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-935-6001
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-0808
Mailing Address - Country:US
Mailing Address - Phone:509-935-6001
Mailing Address - Fax:509-935-4196
Practice Address - Street 1:5952 BLACKSTONE WAY #100
Practice Address - Street 2:
Practice Address - City:NINE MILE FALLS
Practice Address - State:WA
Practice Address - Zip Code:99026
Practice Address - Country:US
Practice Address - Phone:509-464-0002
Practice Address - Fax:509-464-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)