MEDICARE: NEW EXISTENCE 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	324500000X	Substance Abuse Rehabilitation Facility	300384BP	CA

General Provider Information

NPI Number	:	1396247003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW EXISTENCE LLC

Provider Business Mailing Address
First Line	:	PO BOX 2320
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92628-2320
Country	:	US
Telephone Number	:	253-653-2243
Fax Number	:

Provider Business Practice Location Address
First Line	:	423 13TH ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-4524
Country	:	US
Telephone Number	:	253-653-2243
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DYLAN WALKER
Credential	:
Telephone Number	:	253-653-2243

Provider Enumeration Date	:	03/08/2018
Last Update Date	:	03/10/2026

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Directions to “NEW EXISTENCE LLC ” Practice Location

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