1598285702 NPI number — NEW BEGINNING INC

Table of content: (NPI 1598285702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598285702 NPI number — NEW BEGINNING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BEGINNING INC
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:
Provider Other Organization Name Type Code:
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:
1598285702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 277
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAVERLY
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23890-0277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-834-3490
Provider Business Mailing Address Fax Number:
804-834-2338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
429 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAVERLY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23890-3242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-834-3490
Provider Business Practice Location Address Fax Number:
804-834-2338
Provider Enumeration Date:
06/20/2017

Additional Information

Authorized Official

Authorized Official Last Name:
LAMBERT
Authorized Official First Name:
GLORIDINE
Authorized Official Middle Name:
BEASLEY
Authorized Official Title or Position:
CO-EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
804-834-3490

Provider Taxonomy Codes

  • Taxonomy code: 347C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0049477463 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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