MEDICARE: NEW LIFE PROGRAMS, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency	436	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326139296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE PROGRAMS, INC.

Provider Business Mailing Address
First Line	:	850 TIDEWATER DR
Second Line	:	SUITE A
City	:	NORFOLK
State	:	VA
Zip	:	23504-3300
Country	:	US
Telephone Number	:	757-818-9326
Fax Number	:	757-533-9634

Provider Business Practice Location Address
First Line	:	850 TIDEWATER DR
Second Line	:	SUITE A
City	:	NORFOLK
State	:	VA
Zip	:	23504-3300
Country	:	US
Telephone Number	:	757-818-9326
Fax Number	:	757-533-9634

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS ANDREA BEATRICE CLEAVES
Credential	:
Telephone Number	:	757-818-9326

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	03/18/2009

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Directions to “NEW LIFE PROGRAMS, INC. ” Practice Location

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