Provider Demographics
NPI:1295602910
Name:EXODUS NEW BEGINNINGS, LLC
Entity type:Organization
Organization Name:EXODUS NEW BEGINNINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIENE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-296-7419
Mailing Address - Street 1:4024 EUTAW DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8936
Mailing Address - Country:US
Mailing Address - Phone:704-296-7419
Mailing Address - Fax:
Practice Address - Street 1:4641 OLD MONROE RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5311
Practice Address - Country:US
Practice Address - Phone:704-635-3875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty