Healthcare Provider Details

I. General information

NPI: 1710458997
Provider Name (Legal Business Name): THE NEW BEGINNINGS SENIOR LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 CUESTA ABAJO CT NE
ALBUQUERQUE NM
87113-1453
US

IV. Provider business mailing address

1331 CUESTA ABAJO CT NE
ALBUQUERQUE NM
87113-1453
US

V. Phone/Fax

Practice location:
  • Phone: 505-717-2569
  • Fax: 505-214-5603
Mailing address:
  • Phone: 505-717-2569
  • Fax: 505-214-5603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAUNIKKA AYEASHA CLARK
Title or Position: COMMUNITY RELATIONS DIRECTOR
Credential:
Phone: 505-717-2569