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General NPI Number Information
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NPI Number | 1831983287
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Entity Type | Organization
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Legal Business Name | NEWLIFE AND WELLNESS LLC
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 5328 S 29TH LN
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City | PHOENIX
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State | AZ
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Zip | 85041-3417
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Country | US
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Telephone | 480-572-0174
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Fax | 480-572-0174
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Provider Business Mailing Address
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Address Line | 5328 S 29TH LN
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City | PHOENIX
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State | AZ
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Zip | 85041-3417
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Country | US
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Telephone | 480-572-0174
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Fax | 480-572-0174
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Authorized Official
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Title or Position | MANAGER
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Name | MR. CHARLES NDERU
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Credential |
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Telephone | 480-436-0572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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