Healthcare Provider Details

I. General information

NPI: 1952211005
Provider Name (Legal Business Name): NEW LEAF MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11555 CORTEZ AVE
ADELANTO CA
92301-1929
US

IV. Provider business mailing address

18729 MUSKRAT AVE
ADELANTO CA
92301-2337
US

V. Phone/Fax

Practice location:
  • Phone: 760-877-4427
  • Fax:
Mailing address:
  • Phone: 760-877-4427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA UPTERGROVE
Title or Position: PASTOR
Credential:
Phone: 949-377-6004