Provider Demographics
NPI:1245489400
Name:NEW LIFE COMMUNITY SERVICE,LLC
Entity type:Organization
Organization Name:NEW LIFE COMMUNITY SERVICE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MARQURITA
Authorized Official - Last Name:BELFON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-390-2697
Mailing Address - Street 1:PO BOX 5592
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-0592
Mailing Address - Country:US
Mailing Address - Phone:202-390-2106
Mailing Address - Fax:202-269-4503
Practice Address - Street 1:6932 9TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2406
Practice Address - Country:US
Practice Address - Phone:202-390-2106
Practice Address - Fax:202-269-4503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness