Provider Demographics
NPI:1811798101
Name:NEW LIFE CARE LLC
Entity type:Organization
Organization Name:NEW LIFE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REDIAT
Authorized Official - Middle Name:TSEGAYE
Authorized Official - Last Name:MAMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-645-4422
Mailing Address - Street 1:1117 AFFIRMED VW APT 5-103
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-4283
Mailing Address - Country:US
Mailing Address - Phone:720-645-4422
Mailing Address - Fax:
Practice Address - Street 1:2184 S JOPLIN WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-1028
Practice Address - Country:US
Practice Address - Phone:720-645-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care