Provider Demographics
NPI:1912594185
Name:A NEW DAWN MENTAL HEALTH INC
Entity Type:Organization
Organization Name:A NEW DAWN MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BORER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:763-227-7223
Mailing Address - Street 1:38780 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-6696
Mailing Address - Country:US
Mailing Address - Phone:763-227-7223
Mailing Address - Fax:651-317-6332
Practice Address - Street 1:38780 8TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056-6696
Practice Address - Country:US
Practice Address - Phone:763-227-7223
Practice Address - Fax:651-317-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1386000388OtherNPI TYPE 1