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General NPI Number Information
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NPI Number | 1023414448
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS COMMUNITY OUTREACH CENTER
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 1 LAKESHORE DR STE 1640E
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City | LAKE CHARLES
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State | LA
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Zip | 70629-0100
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Country | US
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Telephone | 337-794-5351
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Fax | 337-433-4894
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Provider Business Mailing Address
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Address Line | 1 LAKESHORE DR STE 1640E
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City | LAKE CHARLES
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State | LA
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Zip | 70629-0100
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Country | US
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Telephone | 337-794-5351
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Fax | 337-433-4894
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. PATRICK ANDRE STEWARD
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Credential | M.A.C., III
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Telephone | 337-794-5351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 63703
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License Number State | LA
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