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NPI Code Detail

MEDICARE: YOUR NEW BEGINNING, INC.

MEDICARE: YOUR NEW BEGINNING, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2320600000XIntellectual and/or Developmental Disabilities Residential Treatment FacilityMHL-047-115NC
3251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215106331
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUR NEW BEGINNING, INC.
Provider Business Mailing Address
First Line : PO BOX 1867
Second Line : 7489 ROCKFISH ROAD
City : RAEFORD
State : NC
Zip : 28376-3867
Country : US
Telephone Number : 910-904-0297
Fax Number : 910-904-0296
Provider Business Practice Location Address
First Line : 7489 ROCKFISH ROAD
Second Line :
City : RAEFORD
State : NC
Zip : 28376-6131
Country : US
Telephone Number : 910-904-0297
Fax Number : 910-904-0296
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. AKILIA SLOCUMB
Credential :
Telephone Number : 910-904-0297
Provider Enumeration Date : 02/22/2008
Last Update Date : 05/08/2015

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Directions to “YOUR NEW BEGINNING, INC. ” Practice Location

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