Provider Demographics
NPI:1043792740
Name:NEW LIFE COMMUNITY SERVICES, INC
Entity Type:Organization
Organization Name:NEW LIFE COMMUNITY SERVICES, INC
Other - Org Name:GEMMA
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-298-5482
Mailing Address - Street 1:707 FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060
Mailing Address - Country:US
Mailing Address - Phone:831-427-1007
Mailing Address - Fax:831-454-0545
Practice Address - Street 1:522 CAPITOLA ROAD EXT
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1651
Practice Address - Country:US
Practice Address - Phone:831-334-2111
Practice Address - Fax:831-454-0545
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW LIFE COMMUNITY SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-30
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility