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General NPI Number Information
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NPI Number | 1811433790
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Entity Type | Organization
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Legal Business Name | NEWAY OF LYFE INC
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Dates
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Enumeration Date | 01/16/2017
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 215 W BLUE HERON BLVD APT 2
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-4477
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Country | US
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Telephone | 561-951-1002
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Fax |
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Provider Business Mailing Address
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Address Line | 215 W BLUE HERON BLVD APT 2
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-4477
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Country | US
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Telephone | 561-951-1002
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRITZ PAMPHILE
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Credential |
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Telephone | 786-803-0593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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