Provider Demographics
NPI:1689940363
Name:NEW BEGINNING DSH INC
Entity Type:Organization
Organization Name:NEW BEGINNING DSH INC
Other - Org Name:DAWN SMITH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MASSAGE THREAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-993-0922
Mailing Address - Street 1:3557 INVERRARY BLVD W
Mailing Address - Street 2:LAUDERHILL
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319
Mailing Address - Country:US
Mailing Address - Phone:954-993-0922
Mailing Address - Fax:954-747-1742
Practice Address - Street 1:3557 INVERRARY BLVD W
Practice Address - Street 2:LAUDERHILL
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-7115
Practice Address - Country:US
Practice Address - Phone:954-993-0922
Practice Address - Fax:954-747-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL50997225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty