Organization
NEW BEGINNINGS RESIDENTIAL CARE FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT WATERS (PRESIDENT)
(208) 523-5371
Entity
Organization
Contact information
Practice address
2105 AVOCET DR, AMMON, ID 83406-6606
(208) 523-5371
(208) 524-6282
Mailing address
2416 MESA ST, IDAHO FALLS, ID 83401-3335
(208) 523-5371
(208) 524-6282
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0002970
—
ID
Enumeration date
04/20/2020
Last updated
04/20/2020
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