Road to New Beginnings, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

ROAD TO NEW BEGINNINGS, LLC

Practice address

3255 W Jessica LN
Phoenix, AZ 85041-4346

Phone

(619) 488-7854

NPI assigned

Apr 15, 2022

Last updated

Apr 15, 2022By 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

Komad Gawido

Title

Ceo/Owner

Phone

(619) 488-7854

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1184367344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 W JESSICA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850414346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 W JESSICA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850414346",
            "telephone_number": "619-488-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROAD TO NEW BEGINNINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "GAWIDO",
        "authorized_official_first_name": "KOMAD",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "619-488-7854"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS",
            "identifier": "BH7357",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "roadtonewbeginnings@gmail.com",
            "affiliation": "N",
            "address_1": "3255 W Jessica Ln",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850414346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.