Healthcare Provider Details

I. General information

NPI: 1407048713
Provider Name (Legal Business Name): NEW LIFE HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 SAVANNAH GROVE RD LOT 1
EFFINGHAM SC
29541-6393
US

IV. Provider business mailing address

2707 SAVANNAH GROVE RD LOT 1
EFFINGHAM SC
29541-6393
US

V. Phone/Fax

Practice location:
  • Phone: 910-339-8580
  • Fax: 910-339-8580
Mailing address:
  • Phone: 910-339-8580
  • Fax: 910-339-8580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TEARA JOHNSON
Title or Position: OWNER/DIRECTER
Credential:
Phone: 910-339-8580