Provider Demographics
NPI:1215106331
Name:YOUR NEW BEGINNING, INC.
Entity type:Organization
Organization Name:YOUR NEW BEGINNING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AKILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOCUMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-904-0297
Mailing Address - Street 1:PO BOX 1867
Mailing Address - Street 2:7489 ROCKFISH ROAD
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3867
Mailing Address - Country:US
Mailing Address - Phone:910-904-0297
Mailing Address - Fax:910-904-0296
Practice Address - Street 1:7489 ROCKFISH ROAD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-6131
Practice Address - Country:US
Practice Address - Phone:910-904-0297
Practice Address - Fax:910-904-0296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X
NCMHL-047-115320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8702331Medicaid
NC7806400Medicaid
NC3408061Medicaid