Provider Demographics
NPI:1316181159
Name:NEXT LEVEL COMMUNITY DEVELOPMENT CENTER, INC.
Entity Type:Organization
Organization Name:NEXT LEVEL COMMUNITY DEVELOPMENT CENTER, INC.
Other - Org Name:NEW DAWN COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/NEW DAWN COUNSELING CENTER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-254-3751
Mailing Address - Street 1:688 WALNUT ST
Mailing Address - Street 2:202
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2677
Mailing Address - Country:US
Mailing Address - Phone:478-254-3751
Mailing Address - Fax:478-254-3752
Practice Address - Street 1:688 WALNUT ST
Practice Address - Street 2:202
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2677
Practice Address - Country:US
Practice Address - Phone:478-254-3751
Practice Address - Fax:478-254-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty