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General NPI Number Information
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NPI Number | 1700763125
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Entity Type | Organization
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Legal Business Name | A NEW LEAF, LLC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 5851 BURGOYNE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78233-5103
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Country | US
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Telephone | 210-578-1509
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Fax |
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Provider Business Mailing Address
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Address Line | 5851 BURGOYNE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78233-5103
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Country | US
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Telephone | 210-578-1509
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | DALINDA DANIELS
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Credential |
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Telephone | 210-578-1509
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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 | 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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