Healthcare Provider Details

I. General information

NPI: 1184301350
Provider Name (Legal Business Name): NEW LIFE RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N. BROADWAY
FRESNO CA
93701
US

IV. Provider business mailing address

8839 N CEDAR AVE STE B-4
FRESNO CA
93720-1832
US

V. Phone/Fax

Practice location:
  • Phone: 559-455-8006
  • Fax:
Mailing address:
  • Phone: 559-455-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CINDY FEDELE
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 559-978-1690