Healthcare Provider Details

I. General information

NPI: 1295292803
Provider Name (Legal Business Name): A NEW BEGINNING FOR ME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43535 17TH ST W UNIT 602
LANCASTER CA
93534-5984
US

IV. Provider business mailing address

44734 27TH ST E
LANCASTER CA
93535-2829
US

V. Phone/Fax

Practice location:
  • Phone: 661-471-9321
  • Fax:
Mailing address:
  • Phone: 818-205-8708
  • Fax: 844-367-9513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PRINCESS M WESLEY
Title or Position: CEO
Credential:
Phone: 818-205-8708