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General NPI Number Information
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NPI Number | 1811142938
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Entity Type | Organization
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Legal Business Name | NEW DAY NEW BEGINNING, LLC
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 616 ATLANTIC AVE
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City | ROCKY MOUNT
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State | NC
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Zip | 27801-3406
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Country | US
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Telephone | 252-442-1295
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Fax |
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Provider Business Mailing Address
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Address Line | 616 ATLANTIC AVE
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City | ROCKY MOUNT
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State | NC
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Zip | 27801-3406
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Country | US
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Telephone | 252-442-1295
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CRYSTAL LISETTE GOOLSBY
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Credential |
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Telephone | 252-469-3247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MHL-033-061
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License Number State | NC
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