Provider Demographics
NPI:1245026145
Name:NEW LIGHT SERVICES INC
Entity type:Organization
Organization Name:NEW LIGHT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-313-4938
Mailing Address - Street 1:8075 EDEN PRAIRIE RD APT 245
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-3303
Mailing Address - Country:US
Mailing Address - Phone:424-313-4938
Mailing Address - Fax:
Practice Address - Street 1:3026 15TH AVE S
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-5688
Practice Address - Country:US
Practice Address - Phone:424-313-4938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health