Provider Demographics
NPI:1760175525
Name:NEW LIFE COUNSELING AND EDUCATIONAL SERVICES
Entity Type:Organization
Organization Name:NEW LIFE COUNSELING AND EDUCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELEECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-551-4953
Mailing Address - Street 1:4417 BEACH BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-4728
Mailing Address - Country:US
Mailing Address - Phone:904-551-4953
Mailing Address - Fax:
Practice Address - Street 1:4417 BEACH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4728
Practice Address - Country:US
Practice Address - Phone:904-551-4953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management