Provider Demographics
NPI:1356613616
Name:NEW FOUND LIFE
Entity type:Organization
Organization Name:NEW FOUND LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-715-6210
Mailing Address - Street 1:55 SE 2ND AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3615
Mailing Address - Country:US
Mailing Address - Phone:561-715-6210
Mailing Address - Fax:772-619-8003
Practice Address - Street 1:55 SE 2ND AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-3615
Practice Address - Country:US
Practice Address - Phone:561-715-6210
Practice Address - Fax:772-619-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2040428291U00000X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No291U00000XLaboratoriesClinical Medical Laboratory