Organization
NEW NAME BORN LLC
Active
Other names
Newnameborn
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CYPRIEL FIDELIS NWAFOR (CEO)
(704) 777-5710
Entity
Organization
Contact information
Practice address
11124 FRONT PORCH AVE APT 21107, CHARLOTTE, NC 28227-0049
(704) 777-5710
Mailing address
11124 FRONT PORCH AVE APT 21107, CHARLOTTE, NC 28227-0049
(704) 777-5710
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/12/2024
Last updated
07/31/2024
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