Provider Demographics
NPI:1215216270
Name:NEW BEGINNINGS LAKE COUNTY
Entity type:Organization
Organization Name:NEW BEGINNINGS LAKE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-404-6946
Mailing Address - Street 1:200 E WASHINGTON ST
Mailing Address - Street 2:MINNEOLA
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-9250
Mailing Address - Country:US
Mailing Address - Phone:352-404-6946
Mailing Address - Fax:352-404-6947
Practice Address - Street 1:200 E WASHINGTON ST
Practice Address - Street 2:MINNEOLA
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-9250
Practice Address - Country:US
Practice Address - Phone:352-404-6946
Practice Address - Fax:352-404-6947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL828127956Medicaid