Provider Demographics
NPI:1366083362
Name:NEW ROAD RECOVERY SERVICES INC.
Entity type:Organization
Organization Name:NEW ROAD RECOVERY SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMMY
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-992-5114
Mailing Address - Street 1:38832 FRUITRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-4633
Mailing Address - Country:US
Mailing Address - Phone:661-992-5114
Mailing Address - Fax:661-948-4600
Practice Address - Street 1:155 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-7932
Practice Address - Country:US
Practice Address - Phone:661-992-5114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility