Healthcare Provider Details

I. General information

NPI: 1326859216
Provider Name (Legal Business Name): NEW BEGINNINGS RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2025
Last Update Date: 01/18/2025
Certification Date: 01/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 SW 148TH AVE
DAVIE FL
33325-3015
US

IV. Provider business mailing address

1751 SW 136TH AVE
DAVIE FL
33325-5732
US

V. Phone/Fax

Practice location:
  • Phone: 954-909-8905
  • Fax:
Mailing address:
  • Phone: 954-909-8905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. DONNA ISIDORA
Title or Position: CEO
Credential:
Phone: 954-909-8905