Provider Demographics
NPI:1083710693
Name:NEW DAWN WELLNESS AND RECOVERY CENTER, INC.
Entity type:Organization
Organization Name:NEW DAWN WELLNESS AND RECOVERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:NADINE
Authorized Official - Last Name:LOLLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW, LCAC
Authorized Official - Phone:782-266-0202
Mailing Address - Street 1:1221 SW 17TH STREET
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-2810
Mailing Address - Country:US
Mailing Address - Phone:785-266-0202
Mailing Address - Fax:785-267-3439
Practice Address - Street 1:1221 SW 17TH STREET
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-2810
Practice Address - Country:US
Practice Address - Phone:785-266-0202
Practice Address - Fax:785-267-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS595261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200337010Medicaid