Provider Demographics
NPI:1073071411
Name:NEW BEGINNINGS HOME CARE
Entity Type:Organization
Organization Name:NEW BEGINNINGS HOME CARE
Other - Org Name:NEW BEGINNINGS HOME CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:662-537-5248
Mailing Address - Street 1:116 GREGORY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-7617
Mailing Address - Country:US
Mailing Address - Phone:662-537-5248
Mailing Address - Fax:
Practice Address - Street 1:819 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-4100
Practice Address - Country:US
Practice Address - Phone:662-537-5248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS802511351Medicaid