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General NPI Number Information
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NPI Number | 1871162776
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Entity Type | Organization
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Legal Business Name | NEW LIFE RECOVERY CENTER LLC
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 25 N WENATCHEE AVE STE 214
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City | WENATCHEE
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State | WA
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Zip | 98801-2283
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Country | US
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Telephone | 509-669-9582
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Fax |
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Provider Business Mailing Address
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Address Line | 25 N WENATCHEE AVE STE 214
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City | WENATCHEE
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State | WA
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Zip | 98801-2283
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Country | US
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Telephone | 253-528-6091
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VINCENT SERRATO
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Credential |
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Telephone | 509-668-0092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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