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General NPI Number Information
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NPI Number | 1770086290
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS SUBSTANCE ABUSE SERVICES, INC
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Dates
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Enumeration Date | 03/11/2018
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Last Update Date | 03/11/2018
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Provider Practice Location Address
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Address Line | 200 E INTERSTATE 2 STE O
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City | PHARR
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State | TX
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Zip | 78577-6506
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Country | US
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Telephone | 956-231-0371
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E INTERSTATE 2 STE O
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City | PHARR
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State | TX
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Zip | 78577-6506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ISHMAEL AVILA
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Credential |
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Telephone | 956-231-0371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 4280
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 4280
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License Number State | TX
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