Provider Demographics
NPI:1770018855
Name:NEW BEGINNINGS DRUG TREATMENT CENTER INC
Entity Type:Organization
Organization Name:NEW BEGINNINGS DRUG TREATMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MUCKALEW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:681-319-1235
Mailing Address - Street 1:4855 MCCORKLE AVE SW
Mailing Address - Street 2:NEW BEGINNINGS DRUG TREATMENT CENTER INC
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1331
Mailing Address - Country:US
Mailing Address - Phone:304-853-3869
Mailing Address - Fax:304-853-3869
Practice Address - Street 1:4855 MCCORKLE AVE SW
Practice Address - Street 2:NEW BEGINNINGS DRUG TREATMENT CENTER INC
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1331
Practice Address - Country:US
Practice Address - Phone:304-853-3869
Practice Address - Fax:304-853-3869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2017971900324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility