Provider Demographics
NPI:1942377346
Name:A NEW BEGINNING ADULT AND YOUTH SERVICES INC
Entity Type:Organization
Organization Name:A NEW BEGINNING ADULT AND YOUTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:POWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-695-1728
Mailing Address - Street 1:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:LILESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28091-0616
Mailing Address - Country:US
Mailing Address - Phone:704-695-1728
Mailing Address - Fax:704-994-2780
Practice Address - Street 1:107 C EAST WADE ST
Practice Address - Street 2:SUITE H
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170
Practice Address - Country:US
Practice Address - Phone:704-695-1728
Practice Address - Fax:704-994-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418164Medicaid