Provider Demographics
NPI:1962805838
Name:NEW BEGININGS RESIDENTIAL ASSIST LIVING
Entity type:Organization
Organization Name:NEW BEGININGS RESIDENTIAL ASSIST LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOSHA
Authorized Official - Middle Name:ANTIONETTE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-510-3133
Mailing Address - Street 1:2803 RIVERSIDE PKWY APT 5404
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-8748
Mailing Address - Country:US
Mailing Address - Phone:972-510-3133
Mailing Address - Fax:
Practice Address - Street 1:2803 RIVERSIDE PKWY APT 5404
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-8748
Practice Address - Country:US
Practice Address - Phone:972-510-3133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities