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General NPI Number Information
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NPI Number | 1174832562
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS PROGRAM
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Dates
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Enumeration Date | 10/01/2010
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 415 E HOLLOMAN AVE
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City | AHOSKIE
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State | NC
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Zip | 27910-2314
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Country | US
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Telephone | 252-332-8761
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Fax | 252-332-8700
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Provider Business Mailing Address
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Address Line | 415 E HOLLOMAN AVE
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City | AHOSKIE
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State | NC
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Zip | 27910-2314
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Country | US
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Telephone | 252-332-8761
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Fax | 252-332-8700
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Authorized Official
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Title or Position | CEO
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Name | DR. RANDY LEE BEALE SR.
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Credential | D. MIN
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Telephone | 252-587-3583
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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 |
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License Number State |
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