Provider Demographics
NPI:1952419848
Name:A NEW U INC
Entity Type:Organization
Organization Name:A NEW U INC
Other - Org Name:A NEW U HEALING ARTS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SANDERS
Authorized Official - Last Name:REAVES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:904-389-0030
Mailing Address - Street 1:4570 SAINT JOHNS AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-1848
Mailing Address - Country:US
Mailing Address - Phone:904-389-0030
Mailing Address - Fax:904-389-5511
Practice Address - Street 1:4570 SAINT JOHNS AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-1848
Practice Address - Country:US
Practice Address - Phone:904-389-0030
Practice Address - Fax:904-389-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA31726225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC2181OtherBLUE CROSS