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General NPI Number Information
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NPI Number | 1750852703
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Entity Type | Organization
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Legal Business Name | NEW LIFE TREATMENT CENTER INC.
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 1940 W ORANGEWOOD AVE STE 204
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City | ORANGE
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State | CA
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Zip | 92868-2009
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Country | US
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Telephone | 626-644-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 EAST ORANGEWOOD AVENUE SUITE 205
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City | ORANGE
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State | CA
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Zip | 92868
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Country | US
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Telephone | 626-644-0070
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY MALEK
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Credential |
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Telephone | 714-676-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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