Provider Demographics
NPI:1750705554
Name:NEWLIFE YOUTH AND FAMILY COUNSELING
Entity type:Organization
Organization Name:NEWLIFE YOUTH AND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:EJIOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-371-8015
Mailing Address - Street 1:1609 GREENBRIAR PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7640
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1609 GREENBRIAR PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7640
Practice Address - Country:US
Practice Address - Phone:405-371-8015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEWLIFE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management