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General NPI Number Information
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NPI Number | 1346675733
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Entity Type | Organization
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Legal Business Name | NEW LIFE ASSISTED LIVING
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/04/2013
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Provider Practice Location Address
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Address Line | 6901 SCARLET OAKS DR
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City | ELKRIDGE
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State | MD
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Zip | 21075-6241
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Country | US
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Telephone | 410-796-8602
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Fax | 410-796-8807
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Provider Business Mailing Address
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Address Line | 6901 SCARLET OAKS DR
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City | ELKRIDGE
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State | MD
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Zip | 21075-6241
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Country | US
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Telephone | 410-796-8602
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Fax | 410-796-8807
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALVIN GARRETT THOMAS
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Credential |
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Telephone | 410-926-0419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 13AL180-F
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License Number State | MD
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