MEDICARE: NEW START FOR BRIGHT MINDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1275420689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW START FOR BRIGHT MINDS LLC

Provider Business Mailing Address
First Line	:	638 E 169TH ST # 1314
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-2623
Country	:	US
Telephone Number	:	929-256-5005
Fax Number	:	929-256-5006

Provider Business Practice Location Address
First Line	:	638 E 169TH ST # 1314
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10456-2623
Country	:	US
Telephone Number	:	929-256-5005
Fax Number	:	929-256-5006

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	HECTOR DARIO REYES
Credential	:	MBA
Telephone Number	:	917-771-9827

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	03/23/2026

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Directions to “NEW START FOR BRIGHT MINDS LLC ” Practice Location

Language	Start Address	Practice Location

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