1295358075 NPI number — NEW BEGINNINGS THERAPY AND HEALING, LLC

Table of content: (NPI 1295358075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295358075 NPI number — NEW BEGINNINGS THERAPY AND HEALING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BEGINNINGS THERAPY AND HEALING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEW BEGINNINGS THERAPY AND HEALING, LLC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295358075
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12611 LONGVIEW PARK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEYTON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80831-6998
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-442-9722
Provider Business Mailing Address Fax Number:
719-960-3286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1755 TELSTAR DR FL 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80920-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-428-6024
Provider Business Practice Location Address Fax Number:
719-960-3286
Provider Enumeration Date:
05/27/2020

Additional Information

Authorized Official

Authorized Official Last Name:
RENFROE
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
JOYCE
Authorized Official Title or Position:
OFFICE ADMINISTRATOR
Authorized Official Telephone Number:
719-415-3558

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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