Healthcare Provider Details

I. General information

NPI: 1740617745
Provider Name (Legal Business Name): NEW BEGINNING CARE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2971 ELDRON BLVD SE
PALM BAY FL
32909-6498
US

IV. Provider business mailing address

2971 ELDRON BLVD SE
PALM BAY FL
32909-6498
US

V. Phone/Fax

Practice location:
  • Phone: 321-956-2082
  • Fax: 321-728-9351
Mailing address:
  • Phone: 321-956-2082
  • Fax: 321-728-9351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL11827
License Number StateFL

VIII. Authorized Official

Name: MRS. BRINDA J BRASWELL
Title or Position: OWNER
Credential:
Phone: 321-914-8284