Provider Demographics
NPI:1104130467
Name:NEW BEGINNINGS COMMUNITY CARE
Entity type:Organization
Organization Name:NEW BEGINNINGS COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:REYES
Authorized Official - Last Name:GOSTOMSKI
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:972-442-7774
Mailing Address - Street 1:1314 CANYON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-6684
Mailing Address - Country:US
Mailing Address - Phone:972-442-7774
Mailing Address - Fax:972-442-7774
Practice Address - Street 1:1314 CANYON CREEK RD
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-6684
Practice Address - Country:US
Practice Address - Phone:972-442-7774
Practice Address - Fax:972-442-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services