Provider Demographics
NPI:1184453730
Name:A NEW LIFE FOR A NEW GENERATION
Entity type:Organization
Organization Name:A NEW LIFE FOR A NEW GENERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARQUICA
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-309-2437
Mailing Address - Street 1:6353 W COMMERCE ST STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78237-1069
Mailing Address - Country:US
Mailing Address - Phone:210-309-2437
Mailing Address - Fax:
Practice Address - Street 1:6353 W COMMERCE ST STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-1069
Practice Address - Country:US
Practice Address - Phone:210-309-2437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management