MEDICARE: NEW VINTAGE CHURCH, 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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1730898362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW VINTAGE CHURCH, INC.

Provider Business Mailing Address
First Line	:	6626 W BELOIT RD
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53219-2009
Country	:	US
Telephone Number	:	414-400-8320
Fax Number	:

Provider Business Practice Location Address
First Line	:	6626 W BELOIT RD
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53219-2009
Country	:	US
Telephone Number	:	414-400-8320
Fax Number	:

Authorized Official
Title or Position	:	SENIOR PASTOR/COUNSELOR
Name	:	KEVIN PAUL BARTELME
Credential	:
Telephone Number	:	414-400-8320

Provider Enumeration Date	:	11/22/2022
Last Update Date	:	11/22/2022

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1003872771 — MIDWEST FAMILY MEDICINE CLINIC PC
Practice Location Address:

1598 IMPERIAL CTR , SUITE 2009
WEST PLAINS, MO
65775-1818

Practice Phone: 417-256-6866
Practice Fax: 417-256-4263

1891719373 — MONA DEVANESAN M.D.
Practice Location Address:

2151 45TH ST STE 110
WEST PALM BEACH, FL
33407-2009

Practice Phone: 561-863-4777
Practice Fax: 561-863-0590

1598771883 — THRIFTY PAYLESS INC
Practice Location Address:

1237 WEST CARSON STREET
TORRANCE, CA
90502-2009

Practice Phone: 310-320-4534
Practice Fax:

1215019567 — DR. AARON HACKETT DPT
Practice Location Address:

1791 W 2300 S
WEST VALLEY CITY, UT
84119-2009

Practice Phone: 801-924-4214
Practice Fax: 801-924-4213

1649334251 — RITE AID OF MICHIGAN INC
Practice Location Address:

42481 WEST 13 MILE ROAD
NOVI, MI
48377-2009

Practice Phone: 248-668-8208
Practice Fax:

Directions to “NEW VINTAGE CHURCH, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.