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General NPI Number Information
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NPI Number | 1275711277
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Entity Type | Organization
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Legal Business Name | I AM NEW LIFE MINISTRIES
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 38400 SAN IGNACIO RD
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City | HEMET
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State | CA
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Zip | 92544-9488
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Country | US
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Telephone | 951-767-2575
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Fax | 951-767-0951
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Provider Business Mailing Address
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Address Line | 38400 SAN IGNACIO RD
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City | HEMET
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State | CA
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Zip | 92544-9488
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Country | US
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Telephone | 951-767-2575
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Fax | 951-767-0951
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. FRANK PICA
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Credential |
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Telephone | 951-767-2575
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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 | 330024AN
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License Number State | CA
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