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General NPI Number Information
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NPI Number | 1043792740
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Entity Type | Organization
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Legal Business Name | NEW LIFE COMMUNITY SERVICES, INC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 522 CAPITOLA ROAD EXT
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City | SANTA CRUZ
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State | CA
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Zip | 95062-1651
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Country | US
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Telephone | 831-334-2111
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Fax | 831-454-0545
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Provider Business Mailing Address
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Address Line | 707 FAIR AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95060
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Country | US
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Telephone | 831-427-1007
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Fax | 831-454-0545
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | STACEY PALAU
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Credential |
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Telephone | 831-298-5482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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