Provider Demographics
NPI:1922467059
Name:NEW BEGINNINGS FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:NEW BEGINNINGS FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY MANAGMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLETHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MICKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-210-3815
Mailing Address - Street 1:4970 SPRINGHOUSE FARM RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-9801
Mailing Address - Country:US
Mailing Address - Phone:336-210-3815
Mailing Address - Fax:
Practice Address - Street 1:7240 CROWDER BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-1922
Practice Address - Country:US
Practice Address - Phone:202-361-2772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health