New Beginings at Waverly, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1003743-1-CDT Issued in MN

Legal business name

NEW BEGININGS AT WAVERLY, LLC

Practice address

109 N Shore Dr
Waverly, MN 55390-5517

Phone

(763) 658-5800

Fax

(763) 658-1746

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Brenda Griffin

Title

Controller

Phone

(763) 658-5222

Specialties & licenses 1

Addresses

Tax ID family

New Beginings at Waverly LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• New Beginnings at Waverly, LLC

  • Community/Behavioral Health Agency
  • Waverly, MN
  • NPI 1831413921
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003914656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N SHORE DR",
            "city": "WAVERLY",
            "state": "MN",
            "postal_code": "553905517",
            "telephone_number": "763-658-5800",
            "fax_number": "763-658-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N SHORE DR",
            "city": "WAVERLY",
            "state": "MN",
            "postal_code": "553905517",
            "telephone_number": "763-658-5800",
            "fax_number": "763-658-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BEGININGS AT WAVERLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "763-658-5222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1003743-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Early Bird Outcomes, Inc.
• Emf Webz LLC
• Cindy Grangroth
• Candace Latanya Hanson, M.A., LPCC
• Timarie Leahy, RN
• New Beginnings at Waverly, LLC
• New Beginnings Waverly LLC (Eosis New Beginnings)
• New Beginnings Waverly LLC
• Nordell Family Services LLC
• The Elders Nest LLC

• Substance Abuse Rehabilitation Facility in Waverly, MN
• Providers in Waverly, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.