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General NPI Number Information
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NPI Number | 1043806524
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Entity Type | Organization
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Legal Business Name | NEW CHANCE REHAB LLC
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Dates
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Enumeration Date | 12/18/2020
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 3990 VALLEY BLVD STE A
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City | WALNUT
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State | CA
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Zip | 91789-1531
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Country | US
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Telephone | 626-533-3309
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Fax |
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Provider Business Mailing Address
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Address Line | 3990 VALLEY BLVD STE A
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City | WALNUT
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State | CA
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Zip | 91789-1531
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Country | US
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Telephone | 626-533-3309
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. BRITTANY J ROBERTS-PRICE
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Credential |
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Telephone | 626-533-3309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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