Provider Demographics
NPI:1205076973
Name:NEW LIFE SERVICES INC.
Entity type:Organization
Organization Name:NEW LIFE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:FLOYD
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCAS, P-LCSW
Authorized Official - Phone:910-671-4067
Mailing Address - Street 1:2003 GOODWIN AVE SUITE C
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3197
Mailing Address - Country:US
Mailing Address - Phone:910-671-4067
Mailing Address - Fax:910-671-0383
Practice Address - Street 1:2003 GODWIN AVE STE C
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3197
Practice Address - Country:US
Practice Address - Phone:910-671-4067
Practice Address - Fax:910-671-0383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-078-130324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300185Medicaid