MEDICARE: NEW BEGINNINGS SUPPORTED SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1417572934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BEGINNINGS SUPPORTED SERVICES

Provider Business Mailing Address
First Line	:	774 BRICE AVE
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-3914
Country	:	US
Telephone Number	:	567-204-2167
Fax Number	:

Provider Business Practice Location Address
First Line	:	774 BRICE AVE
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-3914
Country	:	US
Telephone Number	:	567-204-2167
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELLA L ALLEN
Credential	:
Telephone Number	:	567-204-2167

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	06/10/2020

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Directions to “NEW BEGINNINGS SUPPORTED SERVICES ” Practice Location

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