Provider Demographics
NPI:1780318956
Name:A NEW BEGINNING COMMUNITY CARE LLC
Entity type:Organization
Organization Name:A NEW BEGINNING COMMUNITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHAE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-612-2982
Mailing Address - Street 1:1000 NC MUSIC FACTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2951
Mailing Address - Country:US
Mailing Address - Phone:910-612-2982
Mailing Address - Fax:
Practice Address - Street 1:4425 SHARON RD UNIT S723
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3690
Practice Address - Country:US
Practice Address - Phone:910-612-2982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health