Provider Demographics
NPI:1831361898
Name:NEW BEGINNINGS ADULT DAY CARE SERVICES
Entity type:Organization
Organization Name:NEW BEGINNINGS ADULT DAY CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MCCOOL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:601-656-0340
Mailing Address - Street 1:562 LINE ST S
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-2144
Mailing Address - Country:US
Mailing Address - Phone:601-656-0340
Mailing Address - Fax:601-656-0342
Practice Address - Street 1:562 LINE ST S
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:MS
Practice Address - Zip Code:39350-2144
Practice Address - Country:US
Practice Address - Phone:601-656-0340
Practice Address - Fax:601-656-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251C00000X
253Z00000X, 261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1831361898OtherNPI
MS000409021Medicaid