Provider Demographics
NPI:1114110582
Name:NEW LIFE COGNITIVE BEHAVIORAL SERVICES, INC.
Entity Type:Organization
Organization Name:NEW LIFE COGNITIVE BEHAVIORAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DI FRANCISCO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-374-9964
Mailing Address - Street 1:80 AVA CIR
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-8885
Mailing Address - Country:US
Mailing Address - Phone:610-374-9964
Mailing Address - Fax:610-374-9261
Practice Address - Street 1:522 COURT ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3412
Practice Address - Country:US
Practice Address - Phone:610-374-9964
Practice Address - Fax:610-374-9261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA217680251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health