Provider Demographics
NPI:1558828277
Name:NEW BEGINNINGS CENTER FOR YOUTH AND FAMILIES
Entity Type:Organization
Organization Name:NEW BEGINNINGS CENTER FOR YOUTH AND FAMILIES
Other - Org Name:NEW BEGINNINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-917-6338
Mailing Address - Street 1:260 STATE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01331-9311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:508-909-6549
Practice Address - Street 1:260 STATE RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSTON
Practice Address - State:MA
Practice Address - Zip Code:01331-9311
Practice Address - Country:US
Practice Address - Phone:508-917-6338
Practice Address - Fax:508-909-6549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001119201OtherMEDICARE
MA11598284OtherCAQH
MA1568648483Medicaid