Healthcare Provider Details

I. General information

NPI: 1093155277
Provider Name (Legal Business Name): NEW BEGINNINGS LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 PARK ST
MILO ME
04463
US

IV. Provider business mailing address

PO BX 55 90 PARK ST
MILO ME
04463
US

V. Phone/Fax

Practice location:
  • Phone: 207-943-2000
  • Fax: 207-943-2009
Mailing address:
  • Phone: 207-943-2000
  • Fax: 207-943-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberALLS5161
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberALLS5161
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberALLS5161
License Number StateME

VIII. Authorized Official

Name: MRS. TAMMY LYNN MARTIN TRASK
Title or Position: DIRECTOR / PROPRIETER
Credential: MT, CRMA, CNA, PSS
Phone: 207-943-2000