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General NPI Number Information
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NPI Number | 1679809222
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Entity Type | Organization
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Legal Business Name | NEW LIFE HOME CARE
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 109 GREEN ST SUITE 205
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-5061
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Country | US
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Telephone | 910-223-5347
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Fax | 910-223-5348
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Provider Business Mailing Address
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Address Line | 109 GREEN ST SUITE 205
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-5061
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Country | US
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Telephone | 910-223-5347
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Fax | 910-223-5348
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Authorized Official
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Title or Position | DIRECTOR
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Name | TEARA JOHNSON
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Credential |
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Telephone | 910-237-5042
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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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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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