Provider Demographics
NPI:1801947866
Name:NEW BEGINNING THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:NEW BEGINNING THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:706-253-6287
Mailing Address - Street 1:91 SAMMY MCGHEE BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-7703
Mailing Address - Country:US
Mailing Address - Phone:706-253-6287
Mailing Address - Fax:706-253-6289
Practice Address - Street 1:91 SAMMY MCGHEE BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-7703
Practice Address - Country:US
Practice Address - Phone:706-253-6287
Practice Address - Fax:706-253-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBCZQMedicare ID - Type Unspecified
GAP78487Medicare UPIN