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General NPI Number Information
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NPI Number | 1437470242
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS GROUP HOME
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 817 NE 61ST ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73105-6406
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Country | US
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Telephone | 405-810-1655
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Fax |
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Provider Business Mailing Address
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Address Line | 817 NE 61ST ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73105-6406
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Country | US
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Telephone | 405-810-1655
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSELITO A SMITH
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Credential |
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Telephone | 405-301-2606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | K850000382
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | K850000382
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number | K850000382
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | K850000382
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | K850000382
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License Number State | OK
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