Provider Demographics
NPI:1326452228
Name:NEW LIFE ADULT MEDICAL DAY CARE LLC
Entity Type:Organization
Organization Name:NEW LIFE ADULT MEDICAL DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:FARHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-944-1002
Mailing Address - Street 1:7600 CLAYS LN
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2003
Mailing Address - Country:US
Mailing Address - Phone:410-944-1002
Mailing Address - Fax:
Practice Address - Street 1:7600 CLAYS LN
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2003
Practice Address - Country:US
Practice Address - Phone:410-944-1002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30028A261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care