Provider Demographics
NPI:1417568171
Name:A NEW WALK OF LIFE HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:A NEW WALK OF LIFE HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYLITA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-213-5154
Mailing Address - Street 1:1107 N POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3420
Mailing Address - Country:US
Mailing Address - Phone:410-213-5154
Mailing Address - Fax:410-779-3794
Practice Address - Street 1:1107 N POINT BLVD STE 227
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3470
Practice Address - Country:US
Practice Address - Phone:410-213-5154
Practice Address - Fax:410-779-3794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health