Provider Demographics
NPI:1750840005
Name:NEW BEGINNING BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:NEW BEGINNING BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SICIID
Authorized Official - Middle Name:SHRE
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-291-7652
Mailing Address - Street 1:2425 COUNTY ROAD C2 W APT 122
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1073
Mailing Address - Country:US
Mailing Address - Phone:763-291-7652
Mailing Address - Fax:
Practice Address - Street 1:3055 OLD HIGHWAY 8 STE 202
Practice Address - Street 2:
Practice Address - City:SAINT ANTHONY
Practice Address - State:MN
Practice Address - Zip Code:55418-2500
Practice Address - Country:US
Practice Address - Phone:763-291-7652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-17
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01Medicaid