Provider Demographics
NPI:1184861460
Name:NEW LIFE TREATMENT LLC
Entity Type:Organization
Organization Name:NEW LIFE TREATMENT LLC
Other - Org Name:EXECUCARE ARC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-817-0711
Mailing Address - Street 1:3985 STEVE REYNOLDS BLVD
Mailing Address - Street 2:BLDG B SUITE A
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3035
Mailing Address - Country:US
Mailing Address - Phone:770-817-0711
Mailing Address - Fax:770-817-0640
Practice Address - Street 1:3985 STEVE REYNOLDS BLVD
Practice Address - Street 2:BLDG B SUITE A
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3035
Practice Address - Country:US
Practice Address - Phone:770-817-0711
Practice Address - Fax:770-817-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251J00000XAgenciesNursing Care