Provider Demographics
NPI:1518740026
Name:NEW LIFE INC
Entity Type:Organization
Organization Name:NEW LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLUFUNKE
Authorized Official - Middle Name:
Authorized Official - Last Name:AJEPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-851-1894
Mailing Address - Street 1:3104 LORD BALTIMORE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-5801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3104 LORD BALTIMORE DR STE 101
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-5801
Practice Address - Country:US
Practice Address - Phone:443-851-1864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities