Provider Demographics
NPI:1346987237
Name:NEW LIFE FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:NEW LIFE FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:317-366-8249
Mailing Address - Street 1:12683 LARGO DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-8189
Mailing Address - Country:US
Mailing Address - Phone:317-366-8249
Mailing Address - Fax:
Practice Address - Street 1:6745 GRAY RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-3262
Practice Address - Country:US
Practice Address - Phone:317-366-8249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW LIFE FAMILY SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty