Provider Demographics
NPI:1265573901
Name:NEW BEGINNINGS PPA
Entity type:Organization
Organization Name:NEW BEGINNINGS PPA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-390-8321
Mailing Address - Street 1:1478 W 1950 S
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9822
Mailing Address - Country:US
Mailing Address - Phone:801-525-6880
Mailing Address - Fax:801-525-6997
Practice Address - Street 1:1478 W 1950 S
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9822
Practice Address - Country:US
Practice Address - Phone:801-525-6880
Practice Address - Fax:801-525-6997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management