Healthcare Provider Details

I. General information

NPI: 1144988353
Provider Name (Legal Business Name): ANEW BEGINNINGS MENTAL AND BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2021
Last Update Date: 12/04/2021
Certification Date: 12/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CONIFER WAY
SICKLERVILLE NJ
08081-4637
US

IV. Provider business mailing address

15 CONIFER WAY
SICKLERVILLE NJ
08081-4637
US

V. Phone/Fax

Practice location:
  • Phone: 856-524-2415
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ASHAKI TRUITT
Title or Position: OWNER
Credential:
Phone: 856-524-2415