Provider Demographics
NPI:1407449630
Name:BEAUTIFUL BEGINNINGS RESIDENTIAL CARE
Entity Type:Organization
Organization Name:BEAUTIFUL BEGINNINGS RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-418-8313
Mailing Address - Street 1:7316 W CORDES RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-7260
Mailing Address - Country:US
Mailing Address - Phone:623-418-8313
Mailing Address - Fax:
Practice Address - Street 1:6850 W CARSON RD
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-7025
Practice Address - Country:US
Practice Address - Phone:623-418-8313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAUTIFUL BEGINNINGS RESIDENTIAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ274042807Medicaid