Provider Demographics
NPI:1265824940
Name:NEW DAWN INTEGRATED BEHAVIORAL HEALTH CENTER INC.
Entity Type:Organization
Organization Name:NEW DAWN INTEGRATED BEHAVIORAL HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:CLINICAL NURSE SPECI
Authorized Official - Phone:978-627-3929
Mailing Address - Street 1:33 ELECTRIC AVE
Mailing Address - Street 2:SUITE3B
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7954
Mailing Address - Country:US
Mailing Address - Phone:978-627-3929
Mailing Address - Fax:978-400-5328
Practice Address - Street 1:33 ELECTRIC AVE
Practice Address - Street 2:SUITE3B
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7954
Practice Address - Country:US
Practice Address - Phone:978-627-3929
Practice Address - Fax:978-400-5328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN 174905101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty