Healthcare Provider Details

I. General information

NPI: 1336694694
Provider Name (Legal Business Name): A NEW GENERATION LIFE RECOVERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 09/02/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8225 W SAHARA AVE STE C-1
LAS VEGAS NV
89117-8962
US

IV. Provider business mailing address

8225 W SAHARA AVE STE C-1
LAS VEGAS NV
89117-8962
US

V. Phone/Fax

Practice location:
  • Phone: 702-476-2899
  • Fax: 702-213-9001
Mailing address:
  • Phone: 702-684-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YVONNE WILBANKS
Title or Position: PRESIDENT
Credential:
Phone: 702-927-0324