Provider Demographics
NPI:1326267766
Name:THE BRUSON GROUP INC.,
Entity Type:Organization
Organization Name:THE BRUSON GROUP INC.,
Other - Org Name:NEW BEGINNING'S HEALTH CARE PHASE II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:DORINE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:919-345-0045
Mailing Address - Street 1:5309 KYLE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-6101
Mailing Address - Country:US
Mailing Address - Phone:919-345-0045
Mailing Address - Fax:919-266-5469
Practice Address - Street 1:4513 FOX RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5266
Practice Address - Country:US
Practice Address - Phone:919-345-0045
Practice Address - Fax:919-266-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-678320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities