New Beginnings Residential Care Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

NEW BEGINNINGS RESIDENTIAL CARE FACILITY LLC

Practice address

2105 Avocet Dr
Ammon, ID 83406-6606

Phone

(208) 523-5371

Fax

(208) 524-6282

NPI assigned

Apr 20, 2020

Organization subpart

No

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

Authorized official

Name

Brett Waters

Title

President

Phone

(208) 523-5371

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1760002869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 MESA ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013335",
            "telephone_number": "208-523-5371",
            "fax_number": "208-524-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 AVOCET DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066606",
            "telephone_number": "208-523-5371",
            "fax_number": "208-524-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BEGINNINGS RESIDENTIAL CARE FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-523-5371"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A0002970",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Ammon, ID
• Providers in Ammon, ID by specialty
• Assisted Living Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.