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General NPI Number Information
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NPI Number | 1053334284
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Entity Type | Organization
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Legal Business Name | NEW LIFE CARE SERVICES, LLC.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5416 VETERANS MEMORIAL BLVD STE 303
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City | METAIRIE
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State | LA
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Zip | 70003-1747
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Country | US
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Telephone | 504-885-8767
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Fax | 504-885-9757
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Provider Business Mailing Address
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Address Line | 5416 VETERANS MEMORIAL BLVD STE 303
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City | METAIRIE
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State | LA
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Zip | 70003-1747
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Country | US
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Telephone | 504-885-8767
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Fax | 504-885-9757
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. JOHN-CLIFFORD AGBASI OBIH
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Credential | PH.D.
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Telephone | 504-885-8767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | SIL 12125
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License Number State | LA
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