Provider Demographics
NPI:1750908943
Name:NEW LIFE SERVICES LLC.
Entity type:Organization
Organization Name:NEW LIFE SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:RBT,CMT
Authorized Official - Phone:443-657-3495
Mailing Address - Street 1:1624 NORTHWICK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-1622
Mailing Address - Country:US
Mailing Address - Phone:443-657-3495
Mailing Address - Fax:
Practice Address - Street 1:3600 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-2928
Practice Address - Country:US
Practice Address - Phone:443-657-3495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-03
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty