MEDICARE: NEW LEAF FLORIDA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1053727107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LEAF FLORIDA LLC

Provider Business Mailing Address
First Line	:	4828 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3456
Country	:	US
Telephone Number	:	908-400-8606
Fax Number	:

Provider Business Practice Location Address
First Line	:	4828 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3456
Country	:	US
Telephone Number	:	908-400-8606
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. AREL MEISTER-ALDAMA
Credential	:
Telephone Number	:	800-710-4300

Provider Enumeration Date	:	07/09/2014
Last Update Date	:	06/10/2015

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Directions to “NEW LEAF FLORIDA LLC ” Practice Location

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