Provider Demographics
NPI:1770043747
Name:ANEW BEGINNINGS COMMUNITY RESOURCE CENTER
Entity Type:Organization
Organization Name:ANEW BEGINNINGS COMMUNITY RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:QUEEN
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-412-3956
Mailing Address - Street 1:1519 MCARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-4221
Mailing Address - Country:US
Mailing Address - Phone:972-774-8900
Mailing Address - Fax:833-693-0003
Practice Address - Street 1:1519 MCARTHUR DR
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-4221
Practice Address - Country:US
Practice Address - Phone:972-774-8900
Practice Address - Fax:833-693-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-24
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX349875OtherSUPERIOR
TX349875OtherOPIATE ADDICTION REHAB CENTER