Healthcare Provider Details

I. General information

NPI: 1003008541
Provider Name (Legal Business Name): C'S NEW BEGINNINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 TELLURIDE CIR
LEXINGTON KY
40509-2394
US

IV. Provider business mailing address

1240 TELLURIDE CIR
LEXINGTON KY
40509-2394
US

V. Phone/Fax

Practice location:
  • Phone: 859-264-0646
  • Fax: 859-264-7160
Mailing address:
  • Phone: 859-264-0646
  • Fax: 859-264-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateKY

VIII. Authorized Official

Name: MS. VINNIE JOYCE MATHEWS
Title or Position: ADMINISTRATOR/MANAGER
Credential:
Phone: 859-264-0646