Provider Demographics
NPI:1679974646
Name:NEW BEGINNING ASSISTED LIVING
Entity Type:Organization
Organization Name:NEW BEGINNING ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUNIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSME
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:239-822-2310
Mailing Address - Street 1:418 NW 21 TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993
Mailing Address - Country:US
Mailing Address - Phone:239-574-3013
Mailing Address - Fax:
Practice Address - Street 1:418 NW 21ST TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-4159
Practice Address - Country:US
Practice Address - Phone:239-574-3013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12436310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010049400Medicaid