Provider Demographics
NPI:1457756769
Name:NEW BEGINNINGS FAMILY SERVICES
Entity type:Organization
Organization Name:NEW BEGINNINGS FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-394-4442
Mailing Address - Street 1:PO BOX 2464
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-2464
Mailing Address - Country:US
Mailing Address - Phone:907-394-4442
Mailing Address - Fax:907-262-1806
Practice Address - Street 1:224 KENAI AVE STE 3
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7647
Practice Address - Country:US
Practice Address - Phone:907-394-4442
Practice Address - Fax:907-262-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCMX251B00000X
AK1290251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1295996858Medicaid