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General NPI Number Information
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NPI Number | 1316554215
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Entity Type | Organization
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Legal Business Name | A NEW WAY OF LIFE MENTORING SERVICES
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 7601 FM 1960 RD E
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City | HUMBLE
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State | TX
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Zip | 77346-2209
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Country | US
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Telephone | 770-695-8329
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Fax |
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Provider Business Mailing Address
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Address Line | 7601 FM 1960 RD E
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City | HUMBLE
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State | TX
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Zip | 77346-2209
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Country | US
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Telephone | 770-695-8329
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. BIANCA TENE CHENEY-GIBSON
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Credential |
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Telephone | 770-695-8329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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