Provider Demographics
NPI:1174038418
Name:A NEW BEGINNING COMMUNITY CENTER
Entity Type:Organization
Organization Name:A NEW BEGINNING COMMUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-615-9627
Mailing Address - Street 1:5490 BROADWAY STE L-11
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-1663
Mailing Address - Country:US
Mailing Address - Phone:773-615-9627
Mailing Address - Fax:
Practice Address - Street 1:5490 BROADWAY STE L-11
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-1663
Practice Address - Country:US
Practice Address - Phone:773-615-9627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)