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General NPI Number Information
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NPI Number | 1811458573
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Entity Type | Organization
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Legal Business Name | NEW LIFE FOUNDATION RECOVERY INC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 06/22/2019
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Provider Practice Location Address
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Address Line | 11 PARKWAY CIR
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City | NEW CASTLE
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State | DE
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Zip | 19720-4077
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Country | US
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Telephone | 302-562-0639
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Fax | 302-365-5648
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Provider Business Mailing Address
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Address Line | 1541 CHURCH RD
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City | BEAR
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State | DE
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Zip | 19701-1826
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Country | US
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Telephone | 302-317-2212
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Fax | 302-365-5648
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MORGAN N. IKONNE
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Credential |
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Telephone | 302-317-2212
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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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