Healthcare Provider Details

I. General information

NPI: 1770086290
Provider Name (Legal Business Name): NEW BEGINNINGS SUBSTANCE ABUSE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2018
Last Update Date: 03/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E INTERSTATE 2 STE O
PHARR TX
78577-6506
US

IV. Provider business mailing address

200 E INTERSTATE 2 STE O
PHARR TX
78577-6506
US

V. Phone/Fax

Practice location:
  • Phone: 956-231-0371
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number4280
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number4280
License Number StateTX

VIII. Authorized Official

Name: MR. ISHMAEL AVILA
Title or Position: PRESIDENT
Credential:
Phone: 956-231-0371