Healthcare Provider Details

I. General information

NPI: 1528118254
Provider Name (Legal Business Name): NEW BEGINNINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 01/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 E 25TH ST STE 185
IDAHO FALLS ID
83404-7539
US

IV. Provider business mailing address

2235 E 25TH ST STE 185
IDAHO FALLS ID
83404-7539
US

V. Phone/Fax

Practice location:
  • Phone: 208-522-1904
  • Fax: 208-522-8847
Mailing address:
  • Phone: 208-522-1904
  • Fax: 208-522-8847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. BLAIR K GARNER
Title or Position: PRESIDENT
Credential: LCSW
Phone: 208-522-1904