Provider Demographics
NPI:1538302609
Name:NEWLIFE ADDICTIONS PROGRAM INC
Entity Type:Organization
Organization Name:NEWLIFE ADDICTIONS PROGRAM INC
Other - Org Name:HEALTHQUEST INSTITUTE & WELLNESS CENTER, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCPHILAMY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:904-296-1116
Mailing Address - Street 1:3560 CARDINAL POINT DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-9235
Mailing Address - Country:US
Mailing Address - Phone:904-296-1116
Mailing Address - Fax:904-296-1467
Practice Address - Street 1:3560 CARDINAL POINT DR
Practice Address - Street 2:SUITE 102
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-9235
Practice Address - Country:US
Practice Address - Phone:904-296-1116
Practice Address - Fax:904-296-1467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty