Provider Demographics
NPI:1780388306
Name:NEW LIFE RECOVERY CENTER
Entity type:Organization
Organization Name:NEW LIFE RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELKUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:323-683-5502
Mailing Address - Street 1:49349 80TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-9403
Mailing Address - Country:US
Mailing Address - Phone:323-683-5502
Mailing Address - Fax:
Practice Address - Street 1:49349 80TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-9403
Practice Address - Country:US
Practice Address - Phone:323-683-5502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility