Provider Demographics
NPI:1083989156
Name:NEW LIFE COMMUNITY SERVICES, LLC
Entity Type:Organization
Organization Name:NEW LIFE COMMUNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRENITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-814-9937
Mailing Address - Street 1:PO BOX 8611
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-8611
Mailing Address - Country:US
Mailing Address - Phone:252-814-9937
Mailing Address - Fax:
Practice Address - Street 1:201 E PITT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-5192
Practice Address - Country:US
Practice Address - Phone:252-641-1711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health