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General NPI Number Information
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NPI Number | 1528740255
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Entity Type | Organization
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Legal Business Name | NEW LIFE WITH A&B
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 3100 DARTMOUTH ST
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City | BAKERSFIELD
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State | CA
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Zip | 93305-2018
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Country | US
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Telephone | 661-662-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 6508 SKY VIEW DR
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City | BAKERSFIELD
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State | CA
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Zip | 93307-9320
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Country | US
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Telephone | 661-662-4333
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANTWANIQUE WALKER
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Credential |
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Telephone | 666-662-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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