Provider Demographics
NPI: | 1740452267 |
---|---|
Name: | NEW BEGINNINGS TRAUMA AND RECOVERY SERVICES,PLLC |
Entity type: | Organization |
Organization Name: | NEW BEGINNINGS TRAUMA AND RECOVERY SERVICES,PLLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TAMARA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ATKINSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 919-383-3971 |
Mailing Address - Street 1: | 2726 CROASDAILE DR |
Mailing Address - Street 2: | SUITE 210 |
Mailing Address - City: | DURHAM |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27705-2578 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 919-383-3971 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2726 CROASDAILE DR |
Practice Address - Street 2: | SUITE 210 |
Practice Address - City: | DURHAM |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27705-2578 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-383-3971 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-03-25 |
Last Update Date: | 2008-03-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |