Provider Demographics
NPI:1023414448
Name:NEW BEGINNINGS COMMUNITY OUTREACH CENTER
Entity type:Organization
Organization Name:NEW BEGINNINGS COMMUNITY OUTREACH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:STEWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, III
Authorized Official - Phone:337-794-5351
Mailing Address - Street 1:1 LAKESHORE DR STE 1640E
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70629-0100
Mailing Address - Country:US
Mailing Address - Phone:337-794-5351
Mailing Address - Fax:337-433-4894
Practice Address - Street 1:1 LAKESHORE DR STE 1640E
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70629-0100
Practice Address - Country:US
Practice Address - Phone:337-794-5351
Practice Address - Fax:337-433-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA63703251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health