Provider Demographics
NPI:1871029082
Name:NEW BENCHMARK
Entity type:Organization
Organization Name:NEW BENCHMARK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-705-1975
Mailing Address - Street 1:7025 OLD VILLAGE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129
Mailing Address - Country:US
Mailing Address - Phone:705-705-1975
Mailing Address - Fax:
Practice Address - Street 1:1472 W HWY 373
Practice Address - Street 2:
Practice Address - City:AMARGOSA VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89020
Practice Address - Country:US
Practice Address - Phone:435-705-1975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-08
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility