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General NPI Number Information
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NPI Number | 1750908943
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Entity Type | Organization
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Legal Business Name | NEW LIFE SERVICES LLC.
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 07/03/2020
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Provider Practice Location Address
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Address Line | 3600 W MULBERRY ST
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City | BALTIMORE
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State | MD
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Zip | 21229-2928
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Country | US
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Telephone | 443-657-3495
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 NORTHWICK RD
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City | BALTIMORE
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State | MD
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Zip | 21218-1622
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Country | US
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Telephone | 443-657-3495
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JAMES CARLOS PEARSON
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Credential | RBT,CMT
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Telephone | 443-657-3495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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