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General NPI Number Information
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NPI Number | 1114475084
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Entity Type | Organization
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Legal Business Name | NEW LIFE BIRTH SERVICES, LLC
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 5706 BALSA COURT NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111
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Country | US
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Telephone | 505-375-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 320 GOLD AVE SW, STE 620 PMB 1305
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-3210
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Country | US
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Telephone | 505-375-4433
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MJ MONTOYA
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Credential | MBA
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Telephone | 505-375-4433
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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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