Provider Demographics
NPI:1588931851
Name:NEW BEGINNINGS CDS
Entity type:Organization
Organization Name:NEW BEGINNINGS CDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN,
Authorized Official - Phone:314-993-5580
Mailing Address - Street 1:9374 OLIVE BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3253
Mailing Address - Country:US
Mailing Address - Phone:314-993-5580
Mailing Address - Fax:314-991-7745
Practice Address - Street 1:9374 OLIVE BLVD
Practice Address - Street 2:STE 101
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3253
Practice Address - Country:US
Practice Address - Phone:314-993-5580
Practice Address - Fax:314-991-7745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1639381403Medicaid