Provider Demographics
NPI:1669814356
Name:A NEW BEGINNING ASSISSSTED LIVING/ AFC HOME
Entity Type:Organization
Organization Name:A NEW BEGINNING ASSISSSTED LIVING/ AFC HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-854-0131
Mailing Address - Street 1:193 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:MI
Mailing Address - Zip Code:49421-9329
Mailing Address - Country:US
Mailing Address - Phone:231-854-0131
Mailing Address - Fax:
Practice Address - Street 1:298 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:MI
Practice Address - Zip Code:49421-9782
Practice Address - Country:US
Practice Address - Phone:231-854-0131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS640295294310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility