Healthcare Provider Details

I. General information

NPI: 1720309503
Provider Name (Legal Business Name): NEW BEGINNINGS SCL,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 BRYANT WAY SUITE H
BOWLING GREEN KY
42103-7116
US

IV. Provider business mailing address

1051 BRYANT WAY SUITE H
BOWLING GREEN KY
42103-7116
US

V. Phone/Fax

Practice location:
  • Phone: 270-784-1291
  • Fax:
Mailing address:
  • Phone: 270-784-1291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SARA HALL THREET
Title or Position: E.D.
Credential:
Phone: 270-784-1291