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General NPI Number Information
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NPI Number | 1720772163
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Entity Type | Organization
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Legal Business Name | LIFE ANEW BEHAVIORAL HEALTH SERVICES INC
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 27801 EUCLID AVE STE 300
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City | EUCLID
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State | OH
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Zip | 44132-3547
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Country | US
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Telephone | 216-417-1007
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Fax |
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Provider Business Mailing Address
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Address Line | 27801 EUCLID AVE STE 300
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City | EUCLID
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State | OH
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Zip | 44132-3547
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Country | US
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Telephone | 216-417-1007
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISTOPHER HENDERSON
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Credential |
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Telephone | 216-417-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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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 #5
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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