Provider Demographics
NPI:1063084598
Name:NEW LIFE COMMUNITY CENTER INC
Entity type:Organization
Organization Name:NEW LIFE COMMUNITY CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTO MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-590-7674
Mailing Address - Street 1:7840 NW 178TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3649
Mailing Address - Country:US
Mailing Address - Phone:305-590-7674
Mailing Address - Fax:
Practice Address - Street 1:1435 SW 87TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3304
Practice Address - Country:US
Practice Address - Phone:305-590-7674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW LIFE COMMUNITY CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)