Healthcare Provider Details

I. General information

NPI: 1568926715
Provider Name (Legal Business Name): NEW BEGINNINGS RECOVERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 2ND ST STE 203
SEYMOUR IN
47274-2173
US

IV. Provider business mailing address

105 W 2ND ST STE 203
SEYMOUR IN
47274-2173
US

V. Phone/Fax

Practice location:
  • Phone: 812-271-2300
  • Fax: 812-271-1810
Mailing address:
  • Phone: 812-271-2300
  • Fax: 812-271-1810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TERESEA LYNN HIGHAM
Title or Position: OWNER
Credential: MA-MHC
Phone: 812-584-6133