Provider Demographics
NPI:1598901522
Name:A NEW BEGINNING888
Entity Type:Organization
Organization Name:A NEW BEGINNING888
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-615-8602
Mailing Address - Street 1:11208 PLEASANT WOOD LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-6538
Mailing Address - Country:US
Mailing Address - Phone:817-875-5067
Mailing Address - Fax:817-615-8602
Practice Address - Street 1:11208 PLEASANT WOOD LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-6538
Practice Address - Country:US
Practice Address - Phone:817-875-5067
Practice Address - Fax:817-615-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities