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General NPI Number Information
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NPI Number | 1063224970
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Entity Type | Organization
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Legal Business Name | NEW LIFE RECOVERY AND WELLNESS
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 2305 N GATEWAY AVE UNIT 3
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City | HARRIMAN
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State | TN
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Zip | 37748-8684
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Country | US
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Telephone | 865-236-5129
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Fax |
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Provider Business Mailing Address
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Address Line | 1214 AUSTIN HOMES BLVD UNIT 105
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City | KNOXVILLE
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State | TN
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Zip | 37915-1345
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Country | US
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Telephone | 865-236-5129
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY OGLE
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Credential | COUNSELOR
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Telephone | 865-236-5129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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