Provider Demographics
NPI:1104826072
Name:THE NEW BEGINNING FELLOWSHIP CENTER
Entity Type:Organization
Organization Name:THE NEW BEGINNING FELLOWSHIP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALONZO
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-839-2515
Mailing Address - Street 1:16581 BROOKHURST ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-2344
Mailing Address - Country:US
Mailing Address - Phone:714-839-2515
Mailing Address - Fax:714-839-5501
Practice Address - Street 1:16581 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2344
Practice Address - Country:US
Practice Address - Phone:714-839-2515
Practice Address - Fax:714-839-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300120AN103TA0400X
CA300120BN103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300120BNOtherDEPT OF ALCOHOL & DRUG
CA300120ANOtherDEPT OF ALCOHOL AND DRUG