MEDICARE: A NEW GENERATION LIFE RECOVERY CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1336694694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A NEW GENERATION LIFE RECOVERY CENTER INC

Provider Business Mailing Address
First Line	:	8225 W SAHARA AVE STE C-1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8962
Country	:	US
Telephone Number	:	702-684-5830
Fax Number	:

Provider Business Practice Location Address
First Line	:	8225 W SAHARA AVE STE C-1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8962
Country	:	US
Telephone Number	:	702-476-2899
Fax Number	:	702-213-9001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YVONNE WILBANKS
Credential	:
Telephone Number	:	702-927-0324

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	09/02/2025

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