Healthcare Provider Details

I. General information

NPI: 1962131425
Provider Name (Legal Business Name): NEW BEGINNINGS COMMUNITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FIVE GREENTREE CENTRE 525 ROUTE-73 NORTH STE 104
MARLTON NJ
08053
US

IV. Provider business mailing address

FIVE GREENTREE CENTRE 525 ROUTE-73 NORTH STE 104
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 917-519-8362
  • Fax:
Mailing address:
  • Phone: 917-519-8362
  • Fax:

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 State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. RAMEL S CARTER
Title or Position: CEO
Credential:
Phone: 917-519-8362