Provider Demographics
NPI:1699009985
Name:CYNTHIA A NEWCITY LLC
Entity Type:Organization
Organization Name:CYNTHIA A NEWCITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEWCITY
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:404-672-7064
Mailing Address - Street 1:3454 CHASTAIN LAKES DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3058
Mailing Address - Country:US
Mailing Address - Phone:404-672-7064
Mailing Address - Fax:
Practice Address - Street 1:574 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1358
Practice Address - Country:US
Practice Address - Phone:404-672-7064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002292320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness