Basic Information
| Provider Information | |||||||||
| NPI: | 1457648438 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A NEW BEGINNING BEHAVIORAL SERVICES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3900 NW 79TH AVE | ||||||||
| Address2: | SUITE 501 | ||||||||
| City: | DORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331666556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055973861 | ||||||||
| FaxNumber: | 3055973863 | ||||||||
| Practice Location | |||||||||
| Address1: | 3900 NW 79TH AVE | ||||||||
| Address2: | SUITE 501 | ||||||||
| City: | DORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331666556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055973861 | ||||||||
| FaxNumber: | 3055973863 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2011 | ||||||||
| LastUpdateDate: | 06/29/2011 | ||||||||
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| AuthorizedOfficialLastName: | BOUZA-MERIDA | ||||||||
| AuthorizedOfficialFirstName: | CARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3055973861 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 103K00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.