Provider Demographics
NPI:1104199264
Name:NEW BEGINNING HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:NEW BEGINNING HOME HEALTH AGENCY LLC
Other - Org Name:NEW BEGINNING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ONWER/SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:COUNTESS
Authorized Official - Middle Name:MARKIA
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-434-1205
Mailing Address - Street 1:213 MALLEGAN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715
Mailing Address - Country:UM
Mailing Address - Phone:352-434-1205
Mailing Address - Fax:352-602-7952
Practice Address - Street 1:213 MAGELLAN CIR
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-5703
Practice Address - Country:US
Practice Address - Phone:352-434-1205
Practice Address - Fax:352-602-7952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL004370100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health