Provider Demographics
NPI:1063037943
Name:NEWLIFE ASPIRATION BEHAVIOURAL SERVICES, LLC
Entity Type:Organization
Organization Name:NEWLIFE ASPIRATION BEHAVIOURAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHINYERE
Authorized Official - Middle Name:MILLICENT
Authorized Official - Last Name:UGWANYI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:703-474-6362
Mailing Address - Street 1:9408 MORNING WALK DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-1484
Mailing Address - Country:US
Mailing Address - Phone:703-474-6362
Mailing Address - Fax:
Practice Address - Street 1:9408 MORNING WALK DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-1484
Practice Address - Country:US
Practice Address - Phone:703-474-6362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)