Provider Demographics
NPI:1912466459
Name:NEW LIFE MEDICAL DETOXIFICATION LLC
Entity Type:Organization
Organization Name:NEW LIFE MEDICAL DETOXIFICATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAVON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-668-2503
Mailing Address - Street 1:773 ROUTE 70 EAST
Mailing Address - Street 2:SUITE E100
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4128
Mailing Address - Country:US
Mailing Address - Phone:856-942-3700
Mailing Address - Fax:
Practice Address - Street 1:773 ROUTE 70 EAST
Practice Address - Street 2:SUITE E100
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4128
Practice Address - Country:US
Practice Address - Phone:856-942-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty