MEDICARE: NEW LEAF CENTER, 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	:	1710527767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LEAF CENTER, LLC

Provider Business Mailing Address
First Line	:	7934 W NC 10 HWY
Second Line	:
City	:	VALE
State	:	NC
Zip	:	28168-9515
Country	:	US
Telephone Number	:	828-638-3165
Fax Number	:	828-638-3165

Provider Business Practice Location Address
First Line	:	4195 W US HIGHWAY 64 STE 2
Second Line	:
City	:	MURPHY
State	:	NC
Zip	:	28906-8112
Country	:	US
Telephone Number	:	828-835-2420
Fax Number	:	828-835-2423

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. REBECCA ANN RITZ
Credential	:
Telephone Number	:	828-638-3165

Provider Enumeration Date	:	01/07/2020
Last Update Date	:	01/07/2020

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Directions to “NEW LEAF CENTER, LLC ” Practice Location

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