Provider Demographics
NPI:1801273396
Name:NEW LIFE CENTER INC
Entity type:Organization
Organization Name:NEW LIFE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-230-5572
Mailing Address - Street 1:208 COMMERCE PL STE 500
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2325
Mailing Address - Country:US
Mailing Address - Phone:908-230-5572
Mailing Address - Fax:
Practice Address - Street 1:208 COMMERCE PL STE 500
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2325
Practice Address - Country:US
Practice Address - Phone:908-230-5572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service