Provider Demographics
NPI:1285836924
Name:NEW BRANCHES 4 LIFE, INC.
Entity Type:Organization
Organization Name:NEW BRANCHES 4 LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CRAWFORD
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA
Authorized Official - Phone:661-325-2732
Mailing Address - Street 1:1415 18TH ST
Mailing Address - Street 2:#522
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-4430
Mailing Address - Country:US
Mailing Address - Phone:661-325-2732
Mailing Address - Fax:661-325-2101
Practice Address - Street 1:1415 18TH ST
Practice Address - Street 2:#522
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4430
Practice Address - Country:US
Practice Address - Phone:661-325-2732
Practice Address - Fax:661-325-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150034AP261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)