Healthcare Provider Details

I. General information

NPI: 1245531706
Provider Name (Legal Business Name): NEW BEGINNINGS FAMILY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 ASYLUM AVE
HARTFORD CT
06105-1902
US

IV. Provider business mailing address

880 ASYLUM AVE
HARTFORD CT
06105-1902
US

V. Phone/Fax

Practice location:
  • Phone: 860-244-2181
  • Fax: 860-548-1608
Mailing address:
  • Phone: 860-244-2181
  • Fax: 860-548-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number001301
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number001301
License Number StateCT

VIII. Authorized Official

Name: DR. BEVERLY ELAINE COKER
Title or Position: DIRECTOR
Credential: PH.D
Phone: 860-244-2181