New Chance Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

068 Issued in KS

Legal business name

NEW CHANCE INC

Practice address

2500 E Wyatt Earp Blvd
Dodge City, KS 67801-7037

Phone

(620) 225-0476

Fax

(620) 225-0433

NPI assigned

Jul 7, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Derise Unruh, CDAC II NCACII AAP

Title

Executive Director

Phone

(620) 225-0476

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821020314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E WYATT EARP BLVD",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017037",
            "telephone_number": "620-225-0476",
            "fax_number": "620-225-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E WYATT EARP BLVD",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678017037",
            "telephone_number": "620-225-0476",
            "fax_number": "620-225-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CHANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UNRUH",
        "authorized_official_first_name": "DERISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "620-225-0476",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CDAC II  NCACII  AAP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "KS",
            "license": "068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "004998",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.