Provider Demographics
NPI:1467212415
Name:NEW LIFE ASSISTED LIVING FACILITY, LLC
Entity Type:Organization
Organization Name:NEW LIFE ASSISTED LIVING FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-502-4211
Mailing Address - Street 1:562 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-7402
Mailing Address - Country:US
Mailing Address - Phone:561-247-6220
Mailing Address - Fax:561-401-0249
Practice Address - Street 1:562 W 5TH ST
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-7402
Practice Address - Country:US
Practice Address - Phone:561-247-6220
Practice Address - Fax:561-401-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility