Provider Demographics
NPI:1346560265
Name:NEW LIFE HOME HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:NEW LIFE HOME HEALTH CARE AGENCY
Other - Org Name:NEW LIFE HOME CARE & HOSPICE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:APEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-947-8220
Mailing Address - Street 1:2655 PHILMONT AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006
Mailing Address - Country:US
Mailing Address - Phone:215-947-8565
Mailing Address - Fax:215-938-1211
Practice Address - Street 1:2655 PHILMONT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5314
Practice Address - Country:US
Practice Address - Phone:215-947-8565
Practice Address - Fax:215-938-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17231601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100884606-0008Medicaid
PA17231601OtherHEALTH LICENSE
PA17231601OtherHEALTH LICENSE