Healthcare Provider Details

I. General information

NPI: 1215242631
Provider Name (Legal Business Name): NEW BEGINNINGS FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 11/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BARRET AVE
LOUISVILLE KY
40204-1139
US

IV. Provider business mailing address

8151 NEW LAGRANGE ROAD
LOUISVILLE KY
40222-3450
US

V. Phone/Fax

Practice location:
  • Phone: 502-485-0722
  • Fax: 502-485-0792
Mailing address:
  • Phone: 502-400-2369
  • Fax: 502-473-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License NumberKY0940
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES EDWARD GRAHAM
Title or Position: CHIEF FINANCIAL OFFICER
Credential: MBA, MDIV
Phone: 502-400-2369