1689907925 NPI number — NEW BEGINNING COMMUNITY SERVICES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689907925 NPI number — NEW BEGINNING COMMUNITY SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BEGINNING COMMUNITY SERVICES, 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:
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:
1689907925
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 UNION PLAZA 205 NORTH MAIN
Provider Second Line Business Mailing Address:
STREET
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27573-5369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1121 SLATEWORTH DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27703-6182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-358-5901
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MURRAY
Authorized Official First Name:
AYESHA
Authorized Official Middle Name:
RAZIA
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
919-358-5901

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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