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General NPI Number Information
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NPI Number | 1215444955
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Entity Type | Organization
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Legal Business Name | NEW START YOUTH FACILITY INC
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 01/03/2018
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Provider Practice Location Address
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Address Line | 2409 BELVEDERE AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93304
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Country | US
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Telephone | 661-396-8690
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Fax | 661-396-8690
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Provider Business Mailing Address
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Address Line | 6024 FRIANT ST
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City | BAKERSFIELD
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State | CA
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Zip | 93309
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Country | US
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Telephone | 661-487-2158
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Fax | 661-322-1033
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. GINA SODARO
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Credential |
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Telephone | 661-396-8690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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