Provider Demographics
NPI:1003949124
Name:A NEW BEGINNING ADULT AND YOUTH SERVICE INC
Entity Type:Organization
Organization Name:A NEW BEGINNING ADULT AND YOUTH SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:POWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-694-8316
Mailing Address - Street 1:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:LILESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28091-0616
Mailing Address - Country:US
Mailing Address - Phone:704-695-1728
Mailing Address - Fax:704-994-2780
Practice Address - Street 1:107C STE H EAST WADE ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28091-0107
Practice Address - Country:US
Practice Address - Phone:704-695-1728
Practice Address - Fax:704-994-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization