Organization
ROAD TO NEW BEGINNINGS, LLC
Active
Organization
ROAD TO NEW BEGINNINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOMAD GAWIDO (CEO/OWNER)
(619) 488-7854
Entity
Organization
Contact information
Practice address
3255 W JESSICA LN, PHOENIX, AZ 85041-4346
(619) 488-7854
Mailing address
3255 W JESSICA LN, PHOENIX, AZ 85041-4346
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH7357
AZDHS
AZ
Enumeration date
04/15/2022
Last updated
04/15/2022
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